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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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Anastomotic histology in the colon. Each panel shows a tissue segment with the anastomosis in the middle and the mucosal layer at the bottom at a magnification of approximately ×40, representing typical examples obtained at day 3 (a, control; and b, fibrin glue) and day 7 (c, control; and d, fibrin glue). The asterisk denotes fibrin
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Fig7: Anastomotic histology in the colon. Each panel shows a tissue segment with the anastomosis in the middle and the mucosal layer at the bottom at a magnification of approximately ×40, representing typical examples obtained at day 3 (a, control; and b, fibrin glue) and day 7 (c, control; and d, fibrin glue). The asterisk denotes fibrin

Mentions: Typical examples of colonic anastomoses are presented in Fig. 7. No obvious or consistent differences in microscopic wound architecture were seen between groups. Fibrin glue was clearly present in the experimental group at day 3. At day 7, the fibrin glue appeared to be mostly gone. The same was observed in the ileum (not shown).Fig. 7


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 histology in the colon. Each panel shows a tissue segment with the anastomosis in the middle and the mucosal layer at the bottom at a magnification of approximately ×40, representing typical examples obtained at day 3 (a, control; and b, fibrin glue) and day 7 (c, control; and d, fibrin glue). The asterisk denotes fibrin
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3401510&req=5

Fig7: Anastomotic histology in the colon. Each panel shows a tissue segment with the anastomosis in the middle and the mucosal layer at the bottom at a magnification of approximately ×40, representing typical examples obtained at day 3 (a, control; and b, fibrin glue) and day 7 (c, control; and d, fibrin glue). The asterisk denotes fibrin
Mentions: Typical examples of colonic anastomoses are presented in Fig. 7. No obvious or consistent differences in microscopic wound architecture were seen between groups. Fibrin glue was clearly present in the experimental group at day 3. At day 7, the fibrin glue appeared to be mostly gone. The same was observed in the ileum (not shown).Fig. 7

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