Scar tissue is an area of fibrous tissue that replaces normal skin after injury. These scars and scar tissue are a normal part of the healing process and your body needs them for proper would repair. Not only does this happen on the outside of the skin, but inside as well as a result of surgery or some other type of internal trauma. Adhesions form after surgery and are fibrous bands that form between organs and tissues. These adhesions are thought to be a form of scar tissue.
It is important to note that they are a normal part of the body's healing process in response to either inflammation like in irritable bowel disease, diverticulosis, radiation, pelvic inflammatory disease, or surgery. Some estimate that adhesions occur in at least 90% of patients following surgery.
How do these adhesions form? Following injury, the body deposits fibrin, a substance that acts like glue to seal the injury and build new tissue. When this occur between tissues it can cause a band between two structures called an adhesion. While the majority of adhesions are present without any consequence, others can prevent muscles and other tissues from freely moving. This can result in position pain.
Additionally, sometime organs such as the bowels can become twisted. This can actually cause a life-threatening condition, where the blood supply to the bowel becomes compromised. According to the national discharge survey approximately 2000 people die every year from obstruction secondary to adhesion in the United States. 79% of small bowel obstruction are secondary to obstruction, or post-surgical adhesions.
How are these painful scar tissues treated?
There is a spectrum of treatment ranges from conservative management to surgical intervention. The issue with surgery is while it can release the adhesion, post-operative reformation is common, and as such should be reserved for specific indications such as:
- Complete bowel obstruction
- Chronic pain- once less invasive treatment options have been found excluded and other conditions are ruled-out
Non-surgical interventions include anti-inflammatory agents or at the time of initial surgery some have proposed the use of an inert solid barriers to prevent formation of scar tissue to begin with.