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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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Related in: MedlinePlus

Anastomotic breaking strength. Data represent mean and SD for the strength in ileal (a) and colonic (b) anastomoses from the control group (white bars) and the group which received fibrin glue (gray bars). #p < 0.05 vs day 3
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Fig3: Anastomotic breaking strength. Data represent mean and SD for the strength in ileal (a) and colonic (b) anastomoses from the control group (white bars) and the group which received fibrin glue (gray bars). #p < 0.05 vs day 3

Mentions: The early anastomotic breaking strength remained low but increased in both groups between days 3 and 5 (Fig. 3). At all time points, average values in both groups were similar, both in the ileum and colon. Anastomotic bursting pressures remained low at day 1 and day 3, without any differences between the groups, and increased sharply thereafter (Fig. 4). From day 3 to day 5 in the ileum, the average bursting pressure was increased by a factor of 3.17 (p < 0.001) and 2.85 (p < 0.001) in the controls and fibrin glue-treated animals, respectively. In the colon, these factors were 2.44 (p < 0.001) and 2.51 (p < 0.001), respectively. However, 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. Only at day 5, some bursting sites were outside the suture line (Fig. 4).Fig. 3


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)

Anastomotic breaking strength. Data represent mean and SD for the strength in ileal (a) and colonic (b) anastomoses from the control group (white bars) and the group which received fibrin glue (gray bars). #p < 0.05 vs day 3
© Copyright Policy
Related In: Results  -  Collection

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

Fig3: Anastomotic breaking strength. Data represent mean and SD for the strength in ileal (a) and colonic (b) anastomoses from the control group (white bars) and the group which received fibrin glue (gray bars). #p < 0.05 vs day 3
Mentions: The early anastomotic breaking strength remained low but increased in both groups between days 3 and 5 (Fig. 3). At all time points, average values in both groups were similar, both in the ileum and colon. Anastomotic bursting pressures remained low at day 1 and day 3, without any differences between the groups, and increased sharply thereafter (Fig. 4). From day 3 to day 5 in the ileum, the average bursting pressure was increased by a factor of 3.17 (p < 0.001) and 2.85 (p < 0.001) in the controls and fibrin glue-treated animals, respectively. In the colon, these factors were 2.44 (p < 0.001) and 2.51 (p < 0.001), respectively. However, 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. Only at day 5, some bursting sites were outside the suture line (Fig. 4).Fig. 3

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