Fibrous Pleural Adhesions
Adhesions; Fibrous pleural adhesions; Pleural adhesions
Fibrous pleural adhesions are common after any surgical procedure affecting the pleural space. Adhesions form from one pleural surface across to the other pleural surface. The adhesion is generally composed of delicate strands of fibrous tissue.
Injury to the pleural surfaces induces an inflammatory reaction involving cellular elements, tissue factors, and coagulation factors. The early adhesion is made mostly of fibrin gel matrix, which is made of fibrin polymers reacting with fibronectin and amino acids. If the tissue plasminogen activator system does not remove the fibrin gel matrix and fibrinolysis does not occur, connective tissue scarring and adhesions develop from the ingrowth of fibroblasts. Fibrinolysis is impaired by, among other things, ischemia, foreign bodies, bacteria, desiccation, and thermal injury.
Fibrin is deposited at the site of injury fairly quickly after the trauma, and fibrin deposition...
References and Further Reading
- Tanaka, K., Hida, Y., Kaga, K., Kato, H., Iizuka, M., et al. (2010). Video-assisted thoracoscopic surgery lowers the incidence of adhesion to the chest wall but not to the mediastinal and interlobar pleurae. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 20(1), 46–48.CrossRefGoogle Scholar