A Developmental Roadmap Toward Abdominal Adhesions Prevention Technologies.

Abdominal adhesions are a globally disruptive problem to patients and healthcare systems, with limited preventative strategies. Multiple discovery prophylactics have been evaluated previously for adhesions prevention with inadequate transfer to patient care. Clinical translation is fundamentally restricted by the ability of a discovery prophylactic to simultaneously navigate 3 key components of adhesions formation throughout the entire abdomen: the innate immune system, the coagulation system, and the local peritoneal cell populations. Furthermore, challenging handling characteristics and product restrictions have decreased the utilization of clinically available prophylactics by surgeons. The success of future adhesions prevention strategies must also be anchored in clinically valid animal modeling with attention towards future regulatory approval. The purpose of the present roadmap article is to provide a state-of-the-art review of adhesions pathophysiology, hydrogel development, animal modeling, and regulatory science, from which a framework for future developmental strategies may be outlined.