Effect of Peritoneal Trauma on Peritoneal Fibrinolytic Activity and Intraperitoneal Adhesion Formation

Changes in peritoneal fibrinolytic activity have been studied following four types of insult which may occur in the course of abdominal surgery, namely (1) creation of peritoneal defects, (2) free peritoneal grafting, (3) diathermy coagulation and (4) peritoneal ischaemia. Free peritoneal grafting, diathermy, and peritoneal ischaemia are associated with a significant depression of fibrinolytic activity compared with unsutured peritoneal defects and are also associated with a significant increase in adhesion formation. Fibrinolytic activity is not maximally depressed at the time of operation and further depression occurs during the first 24 h post-operatively. Depression of fibrinolytic activity may be a significant factor in the aetiology of intraperitoneal adhesions.