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The effect of fibrin glue on the early healing phase of intestinal anastomoses in the rat.

van der Vijver RJ, van Laarhoven CJ, de Man BM, Lomme RM, Hendriks T - Int J Colorectal Dis (2012)

Bottom Line: At day 5, the bursting pressure in the fibrin glue group remained below than that in the controls, although only significantly (p = 0.0138) so in the ileum.At day 5, but not at day 7, the wounds in the fibrin glue group contained less collagen.Other aspects of microscopic wound architecture appeared to be the same.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands. r.vandervijver@chir.umcn.nl

ABSTRACT

Purpose: Protecting the anastomotic integrity using suture or staple line reinforcement remains an important goal for ongoing research. The present comprehensive study aims to establish the effects of fibrin glue on the early phase of anastomotic healing in the rat intestine.

Methods: One hundred and eight young adult male Wistar rats underwent resection and anastomosis of both the ileum and colon. In half, fibrin glue was applied around the anastomoses. Parameters for repair included wound strength, both bursting pressure and breaking strength at days 1, 3, and 5 after operation; hydroxyproline content; and histology, the latter also after 7 days.

Results: A transient colonic ileus was observed in the experimental group. Anastomotic breaking strength was always similar in both the control and fibrin glue groups. Anastomotic bursting pressures remained low at days 1 and 3, without any differences between the groups. In both groups, the bursting pressure increased sharply (p < 0.001) between days 3 and 5. At day 5, the bursting pressure in the fibrin glue group remained below than that in the controls, although only significantly (p = 0.0138) so in the ileum. At day 5, but not at day 7, the wounds in the fibrin glue group contained less collagen. Other aspects of microscopic wound architecture appeared to be the same.

Conclusions: There is no justification for using fibrin glue on patent anastomoses constructed under low-risk conditions. Its potential benefit under conditions where chances for anastomotic leakage are enhanced needs further investigation.

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Macroscopic findings in the colonic anastomosis on days 1 (a and d), 3 (b and e), and 5 (c and f) in the control (left side) and fibrin glue (right side) groups
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Fig2: Macroscopic findings in the colonic anastomosis on days 1 (a and d), 3 (b and e), and 5 (c and f) in the control (left side) and fibrin glue (right side) groups

Mentions: At day 3, 10 out of 16 rats from the fibrin glue group showed signs of a wide colon filled with hardened feces, immediately proximal to the anastomosis (Fig. 2e), which nevertheless remained conductant. This phenomenon, which was absent in the controls, was seen in only one rat at day 5 and in none of the rats on day 7. In addition, Fig. 2 represents the macroscopic findings at termination at days 1, 3, and 5 in the colonic anastomosis. On day 1, the fibrin glue was still present (lifted by the forceps on Fig. 2d), and on day 5, there were some adhesions to the fibrin glue (Fig. 2f), but adhesions were also present in the control group.Fig. 2


The effect of fibrin glue on the early healing phase of intestinal anastomoses in the rat.

van der Vijver RJ, van Laarhoven CJ, de Man BM, Lomme RM, Hendriks T - Int J Colorectal Dis (2012)

Macroscopic findings in the colonic anastomosis on days 1 (a and d), 3 (b and e), and 5 (c and f) in the control (left side) and fibrin glue (right side) groups
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3401510&req=5

Fig2: Macroscopic findings in the colonic anastomosis on days 1 (a and d), 3 (b and e), and 5 (c and f) in the control (left side) and fibrin glue (right side) groups
Mentions: At day 3, 10 out of 16 rats from the fibrin glue group showed signs of a wide colon filled with hardened feces, immediately proximal to the anastomosis (Fig. 2e), which nevertheless remained conductant. This phenomenon, which was absent in the controls, was seen in only one rat at day 5 and in none of the rats on day 7. In addition, Fig. 2 represents the macroscopic findings at termination at days 1, 3, and 5 in the colonic anastomosis. On day 1, the fibrin glue was still present (lifted by the forceps on Fig. 2d), and on day 5, there were some adhesions to the fibrin glue (Fig. 2f), but adhesions were also present in the control group.Fig. 2

Bottom Line: At day 5, the bursting pressure in the fibrin glue group remained below than that in the controls, although only significantly (p = 0.0138) so in the ileum.At day 5, but not at day 7, the wounds in the fibrin glue group contained less collagen.Other aspects of microscopic wound architecture appeared to be the same.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands. r.vandervijver@chir.umcn.nl

ABSTRACT

Purpose: Protecting the anastomotic integrity using suture or staple line reinforcement remains an important goal for ongoing research. The present comprehensive study aims to establish the effects of fibrin glue on the early phase of anastomotic healing in the rat intestine.

Methods: One hundred and eight young adult male Wistar rats underwent resection and anastomosis of both the ileum and colon. In half, fibrin glue was applied around the anastomoses. Parameters for repair included wound strength, both bursting pressure and breaking strength at days 1, 3, and 5 after operation; hydroxyproline content; and histology, the latter also after 7 days.

Results: A transient colonic ileus was observed in the experimental group. Anastomotic breaking strength was always similar in both the control and fibrin glue groups. Anastomotic bursting pressures remained low at days 1 and 3, without any differences between the groups. In both groups, the bursting pressure increased sharply (p < 0.001) between days 3 and 5. At day 5, the bursting pressure in the fibrin glue group remained below than that in the controls, although only significantly (p = 0.0138) so in the ileum. At day 5, but not at day 7, the wounds in the fibrin glue group contained less collagen. Other aspects of microscopic wound architecture appeared to be the same.

Conclusions: There is no justification for using fibrin glue on patent anastomoses constructed under low-risk conditions. Its potential benefit under conditions where chances for anastomotic leakage are enhanced needs further investigation.

Show MeSH
Related in: MedlinePlus