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Healing of ischemic colonic anastomosisFibrin sealant does not improve wound healing

 

作者: Arie van der Ham,   Wil Kort,   Ineke Weijma,   Harry van den Ingh,   Hans Jeekel,  

 

期刊: Diseases of the Colon & Rectum  (OVID Available online 1992)
卷期: Volume 35, issue 9  

页码: 884-891

 

ISSN:0012-3706

 

年代: 1992

 

出版商: OVID

 

关键词: Rat;Colon;Anastomosis;Wound healing;Tissue adhesive;Ischemia;Bursting pressure;Collagen;Adhesions

 

数据来源: OVID

 

摘要:

&NA;Fibrin adhesives have been advocated as a protective sealant in high‐risk colonic anastomoses to prevent leakage. To assess the effect of fibrin glue sealing on the healing ischemic anastomosis, we compared the healing of sutured colonic anastomoses in the rat, with and without fibrin adhesive (Groups IA and IB), and ischemic anastomoses with and without fibrin adhesive (Groups IIA and IIB). On days two, four, and seven, 10 animals in each group were sacrificed. Adhesion formation was scored, and thein situbursting pressure was measured. The collagen concentration and degradation were estimated by measuring hydroxyproline. Adhesion formation was more prominent in Groups IB, IIA, and IIB on day four only; abscesses were noted in the ischemic group in four rats. Anastomotic bursting pressure was significantly lower in sealed (IB) and ischemic anastomoses (IIA) than in normal anastomoses (IA) on day four. Sealing of ischemic anastomoses did not change bursting pressures on days two, four, and seven. The relative decrease of collagen in the sealed anastomoses is significantly higher on day four only. It is concluded that sealing of normal colonic anastomoses in the rat has a negative effect on wound healing. Ischemia at the anastomotic site results in weaker anastomotic strength on day four postoperatively. Also in ischemic anastomoses, fibrin sealant does not improve wound healing during the first seven days. Adhesion formation on ischemic intestinal anastomoses was not prevented by fibrin sealing.

 

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