Micro-PET allows high throughput assessment of lesion count and volume in pre-clinical rat model of CPL abdominal sepsis.

In the perioperative phase, sepsis is associated with high morbidity and mortality and is the most important problem for the surgeon. Critically ill patients profit from an early identification and implementation of an interdisciplinary diagnostic and therapy. The purpose of this review on septic peritonitis is to give an update on the diagnosis by the use of image examination, mainly Fluor18-FDG pet scan. Methods: The literature for this review was collected with PubMed and SciElo search using the combination of "FDG," "peritonitis" "sepsis," and the specific terms for sepsis. Results: Rapid diagnosis for sepsis is essential for patient´s survival. A bundle of studies was performed on early recognition and on new diagnostic tools for abdominal sepsis. Although surgical intervention is considered as an essential therapeutic step in abdominal sepsis therapy, the time-point of diagnostic and source control is still controversially discussed in the literature. Conclusion: Despite many efforts, mortality of abdominal septic patients remains unacceptably high, the early diagnosis of sepsis is challenging for health care providers, and high performance methods of radiographic imaging like positron emission tomography scan can be helpful in some cases. Their diagnostic impact has to be evaluated in future studies.

Background/Purpose: Hypovolemia and shock is increasingly frequent in the perioperative of intestinal anastomoses, especially due to abdominal trauma. The aim of this study is to evaluate the effects of hemorrhagic shock in the healing of intestinal anastomoses in rats. Methods: It was analyzed the shock interference on the strength of ileum anastomoses. Histologically, structural changes of the anastomotic segments were assessed by two pathologists. Data are given as mean ± SEM. The animals were randomly selected and assigned in two groups with six rats each: Group 1-rats with hypovolemic shock (shocked+enterectomy) treated with fresh whole blood. Group 2-rats not shocked, untreated + enterectomy. Results: The intestinal anastomosis bursting pressure of shock+enterectomy group rats was lower than in the unshocked+enterectomy group, and the difference was significant (p=0.001). In the hemorrhagic shock+enterectomy group rats the density of collagen and fibrous tissue was lower and inflammation/foreign body reaction was higher than in the unshocked+enterectomy group, featuring a more immature and deficient healing. Conclusion: In conclusion, the results show that the hypovolemic shock affects the ileum wound healing, causing a decrease in the bursting pressure (mmHg) of ileal anastomosis, leading to the fragility of the surgical wound.

Background/objetive: The liver ischemia and reperfusion is important for procedures occurring in liver and intestinal trauma injuries that require intestinal resection and anastomosis. The aim of this study was to evaluate the influence of hepatic ischemia/reperfusion in vivo in the healing of duodenal anastomoses. Methods: Wistar rats were randomly selected and allocated into two groups of six animals each: liver ischemia/reperfusion + duodenal anastomosis group and duodenal anastomoses group. Hepatic ischemia was induced for 30 minutes by occlusion of the vessels that supply the median and lateral lobes of the liver, using a microvascular clip. In all rats the duodenum was sectioned and an end-to-end anastomosis was performed. After liver reperfusion, animals were observed for 6 days; the maximum bursting pressure of anastomoses was determined and duodenum samples were taken for histopathological examination. Results: As a result, the maximum bursting pressure of anastomosis in ischemia/reperfusion + duodenal anastomosis group (64.5±5.5mmHg) was significantly lower (p<0.001) than in duodenal anastomosis group rats (89.7±3.4mmHg). The inflammatory tissue response in ischemia/reperfusion + duodenal anastomosis group had scores higher than in duodenal anastomosis group rats (p=0.004). Conclusion: In conclusion, the hepatic ischemia-reperfusion negatively affected the healing process of duodenal anastomoses.

Background/purpose: There is an increasing discussion concerning the deleterious effect of hyperglycemia on the wound healing. Patients with sepsis are subjected not only to high risk of death, but are also vulnerable to developing problems related to deficient healing. The aim of this study was to examine the interference of abdominal sepsis and diabetes on the healing of skin in a rat experimental model. Methods: Wistar rats (Rattus norvegicus) weighing 282±34g randomly distributed into 4 groups of 6 animals each. Twelve animals were subjected to abdominal sepsis with cecal ligation and puncture (CLP) and 12 without sepsis. Six animals from each subgroup had induction of diabetes induced with streptozotocin 50 mg/kg, i.p. and six were non-diabetic. Six days after sepsis induction, a tensile strength test of skin scar from abdominal wall and histopatology of skin wound were carried out. Results: The tensile strength showed a significant difference between groups. The control group rats had a tensile strength of 219.0±12.4 gf/cm2, significantly higher than in the diabetes group (185.2±5,9gf/cm2) and in the sepsis group (107.0±9,8mg/cm2) respectively. The group of animals subjected to sepsis + diabetes had the lowest mean tensile strength (86.3±6,6gf/cm2), significantly lower than the results from other groups (p<0.0001). The isolated sepsis was more detrimental to wound healing than the isolated diabetes. The existence of the two comorbidities resulted in the lower tensile strength of the scar tissue. The control group rats exhibited an inflammatory reaction score (4.67±0.16) significantly lower (p=0.002) than the scores exhibited by the sepsis + diabetes group (5.98 ± 0.27), the sepsis group (5.04 ± 0.23) and the diabetes group (4.95 ± 0.32). Conclusion: Sepsis and diabetes, alone or in combination, negatively influenced the healing of skin wounds in rats. Therefore, the data indicates that sepsis and diabetes may operate as deleterious to the wound healing.