Adaptive

On day 1 between the contacting with each other wound is pronounced layer, consisting of strands of fibrin, the surrounding tissue infiltrated with macrophages and lymphocytes, swollen, red-blooded. On the third day revealed young fibroblasts, a small number kallogenovyh fibrils. At this period there was a process of tumor capillaries, which is manifested in the appearance of reniform outgrowths of capillaries and arterioles. In the spikes occur leyomiotsity unit, whose source, providimomu is the muscular layer of the intestinal wall, as well as single isolated adipocytes. At the 14 day basis adhesions are fibrous connective tissue, which contains more differentiated vessels smaller than the earlier period, the number of capillaries, a large number of dissociated smooth muscle cells. Adhesions are covered mezoteliotsitami, isolated pockets of lymphocytic infiltration. On these terms appear elastic fibers, which were originally located in the same direction as the collagen, there are also single elastic fibers on the surface adhesions.

Drawing on research data, we can distinguish five phases adgeziogeneza if damaged peritoneum:

1. Reactive phase (the first 12 hours) - clinical and morphological signs of shock, the damage is determined by the peritoneum.
2. Phase exudation (1-3 days). Exudation processes prevail brand viagra online over other processes of inflammation. Increased vascular permeability, which contributes to the exit into the free peritoneal cavity of peritoneal undifferentiated pluripotent cells, inflammatory cialis without prescription cells and the liquid part of blood containing fibrinogen.
3. Phase of adhesion (3 days). Loss of fibrin on the damaged surfaces, their bonding. Peritoneal exudate cells are pluripotent and differentiate into fibroblasts that produce collagen.
4. Phase young adhesions (7-14 days). Forms a loose, containing insufficient amount of collagen adhesions. Occurs in tumor vascular adhesions and migration of smooth muscle cells in it.
5. Phase mature adhesions (14-30 days). Formation of dense connective tissue adhesions due to production and packing of collagen, reduction of the capillary bed, perikalibrovka vessels.

Conclusions:

1. Fundamental differences in the structure of adhesions that occur after various injuries, was not revealed.
2. Abdominal adhesions formed at the contact of two wound surfaces, and for the formation of strong adhesions prerequisite is deeply damage the peritoneum.
3. In the area of ischemia often develop peritoneal adhesions gland, leading to the vascularization of the damaged peritoneum.
4. The process of formation of adhesions occurs in several stages, regularly succeed each other, and culminating in the formation of connective tissue adhesions.
5. In the process of genesis of adhesions generic levitra of the abdominal cavity, not all defects are recovered with the outcome in the connective tissue adhesions. Some of them rapidly mezorteliziruetsya and some passing phase of loose adhesions, dissolves later.
6. The healing process damages the peritoneum can occur in two ways: fast mezotelizatsii defect or education adhesions. which subsequently can either dissolve or turn into a dense connective tissue adhesions that may subsequently cause the Security Council and including intestinal obstruction.
7. The process of abdominal adhesion formation is a complex, multi-faceted both protective and adaptive and pathological phenomenon. It can not be considered until the end of studied and requires further research.

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