Attenuation of postoperative adhesions using a modeled manual therapy

Geoffrey M. Bove, Susan L. Chapelle, Katherine E. Hanlon, Michael Peter Diamond, David J. Mokler

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Postoperative adhesions are pathological attachments that develop between abdominopelvic structures following surgery. Considered unavoidable and ubiquitous, postoperative adhesions lead to bowel obstructions, infertility, pain, and reoperations. As such, they represent a substantial health care challenge. Despite over a century of research, no preventive treatment exists. We hypothesized that postoperative adhesions develop from a lack of movement of the abdominopelvic organs in the immediate postoperative period while rendered immobile by surgery and opiates, and tested whether manual therapy would prevent their development. In a modified rat cecal abrasion model, rats were allocated to receive treatment with manual therapy or not, and their resulting adhesions were quantified. We also characterized macrophage phenotype. In separate experiments we tested the safety of the treatment on a strictureplasty model, and also the efficacy of the treatment following adhesiolysis. We show that the treatment led to reduced frequency and size of cohesive adhesions, but not other types of adhesions, such as those involving intraperitoneal fatty structures. This effect was associated with a delay in the appearance of trophic macrophages. The treatment did not inhibit healing or induce undesirable complications following strictureplasty. Our results support that that maintained movements of damaged structures in the immediate postoperative period has potential to act as an effective preventive for attenuating cohesive postoperative adhesion development. Our findings lay the groundwork for further research, including mechanical and pharmacologic approaches to maintain movements during healing.

Original languageEnglish (US)
Article numbere0178407
JournalPloS one
Volume12
Issue number6
DOIs
StatePublished - Jun 1 2017

Fingerprint

Musculoskeletal Manipulations
adhesion
Adhesion
therapeutics
Postoperative Period
Opiate Alkaloids
Macrophages
Surgery
Therapeutics
Rats
macrophages
surgery
Reoperation
Research
Infertility
Health care
Abrasion
Delivery of Health Care
health services
Phenotype

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Bove, G. M., Chapelle, S. L., Hanlon, K. E., Diamond, M. P., & Mokler, D. J. (2017). Attenuation of postoperative adhesions using a modeled manual therapy. PloS one, 12(6), [e0178407]. https://doi.org/10.1371/journal.pone.0178407

Attenuation of postoperative adhesions using a modeled manual therapy. / Bove, Geoffrey M.; Chapelle, Susan L.; Hanlon, Katherine E.; Diamond, Michael Peter; Mokler, David J.

In: PloS one, Vol. 12, No. 6, e0178407, 01.06.2017.

Research output: Contribution to journalArticle

Bove, Geoffrey M. ; Chapelle, Susan L. ; Hanlon, Katherine E. ; Diamond, Michael Peter ; Mokler, David J. / Attenuation of postoperative adhesions using a modeled manual therapy. In: PloS one. 2017 ; Vol. 12, No. 6.
@article{c6f9377965ba45b3a19aa15ca0ec7893,
title = "Attenuation of postoperative adhesions using a modeled manual therapy",
abstract = "Postoperative adhesions are pathological attachments that develop between abdominopelvic structures following surgery. Considered unavoidable and ubiquitous, postoperative adhesions lead to bowel obstructions, infertility, pain, and reoperations. As such, they represent a substantial health care challenge. Despite over a century of research, no preventive treatment exists. We hypothesized that postoperative adhesions develop from a lack of movement of the abdominopelvic organs in the immediate postoperative period while rendered immobile by surgery and opiates, and tested whether manual therapy would prevent their development. In a modified rat cecal abrasion model, rats were allocated to receive treatment with manual therapy or not, and their resulting adhesions were quantified. We also characterized macrophage phenotype. In separate experiments we tested the safety of the treatment on a strictureplasty model, and also the efficacy of the treatment following adhesiolysis. We show that the treatment led to reduced frequency and size of cohesive adhesions, but not other types of adhesions, such as those involving intraperitoneal fatty structures. This effect was associated with a delay in the appearance of trophic macrophages. The treatment did not inhibit healing or induce undesirable complications following strictureplasty. Our results support that that maintained movements of damaged structures in the immediate postoperative period has potential to act as an effective preventive for attenuating cohesive postoperative adhesion development. Our findings lay the groundwork for further research, including mechanical and pharmacologic approaches to maintain movements during healing.",
author = "Bove, {Geoffrey M.} and Chapelle, {Susan L.} and Hanlon, {Katherine E.} and Diamond, {Michael Peter} and Mokler, {David J.}",
year = "2017",
month = "6",
day = "1",
doi = "10.1371/journal.pone.0178407",
language = "English (US)",
volume = "12",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "6",

}

TY - JOUR

T1 - Attenuation of postoperative adhesions using a modeled manual therapy

AU - Bove, Geoffrey M.

AU - Chapelle, Susan L.

AU - Hanlon, Katherine E.

AU - Diamond, Michael Peter

AU - Mokler, David J.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Postoperative adhesions are pathological attachments that develop between abdominopelvic structures following surgery. Considered unavoidable and ubiquitous, postoperative adhesions lead to bowel obstructions, infertility, pain, and reoperations. As such, they represent a substantial health care challenge. Despite over a century of research, no preventive treatment exists. We hypothesized that postoperative adhesions develop from a lack of movement of the abdominopelvic organs in the immediate postoperative period while rendered immobile by surgery and opiates, and tested whether manual therapy would prevent their development. In a modified rat cecal abrasion model, rats were allocated to receive treatment with manual therapy or not, and their resulting adhesions were quantified. We also characterized macrophage phenotype. In separate experiments we tested the safety of the treatment on a strictureplasty model, and also the efficacy of the treatment following adhesiolysis. We show that the treatment led to reduced frequency and size of cohesive adhesions, but not other types of adhesions, such as those involving intraperitoneal fatty structures. This effect was associated with a delay in the appearance of trophic macrophages. The treatment did not inhibit healing or induce undesirable complications following strictureplasty. Our results support that that maintained movements of damaged structures in the immediate postoperative period has potential to act as an effective preventive for attenuating cohesive postoperative adhesion development. Our findings lay the groundwork for further research, including mechanical and pharmacologic approaches to maintain movements during healing.

AB - Postoperative adhesions are pathological attachments that develop between abdominopelvic structures following surgery. Considered unavoidable and ubiquitous, postoperative adhesions lead to bowel obstructions, infertility, pain, and reoperations. As such, they represent a substantial health care challenge. Despite over a century of research, no preventive treatment exists. We hypothesized that postoperative adhesions develop from a lack of movement of the abdominopelvic organs in the immediate postoperative period while rendered immobile by surgery and opiates, and tested whether manual therapy would prevent their development. In a modified rat cecal abrasion model, rats were allocated to receive treatment with manual therapy or not, and their resulting adhesions were quantified. We also characterized macrophage phenotype. In separate experiments we tested the safety of the treatment on a strictureplasty model, and also the efficacy of the treatment following adhesiolysis. We show that the treatment led to reduced frequency and size of cohesive adhesions, but not other types of adhesions, such as those involving intraperitoneal fatty structures. This effect was associated with a delay in the appearance of trophic macrophages. The treatment did not inhibit healing or induce undesirable complications following strictureplasty. Our results support that that maintained movements of damaged structures in the immediate postoperative period has potential to act as an effective preventive for attenuating cohesive postoperative adhesion development. Our findings lay the groundwork for further research, including mechanical and pharmacologic approaches to maintain movements during healing.

UR - http://www.scopus.com/inward/record.url?scp=85020305374&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85020305374&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0178407

DO - 10.1371/journal.pone.0178407

M3 - Article

VL - 12

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 6

M1 - e0178407

ER -