The occurrence of omental and intestinal adhesions after laparotomy has been a source of trouble ever since asepsis permitted the surgeon to open the peritoneum, and frequently these adhesions give rise to more acute symptoms than the condition for which the operation was done. At first adhesions were recognized only by the occurrence of intestinal obstruction, but later surgeons noted that a picture of dull, dragging pain or of partial obstruction after a laparotomy was the result of the presence of omental bands and intestinal adhesions.
Many theories have arisen as to the etiologic factors concerned in the production of adhesions, although little experimental work has been done. Every surgeon is familiar with the protective action of omentum and of fibrinous exudate in the walling off of infection or perforation. Without this protective action, the mortality resulting from many procedures would be considerably greater than it is. It is only
MULLER GP, RADEMAKER LA. RÔLE OF INFECTION IN THE PRODUCTION OF POSTOPERATIVE ADHESIONS. Arch Surg. 1933;26(2):280-287. doi:10.1001/archsurg.1933.01170020114009