Effect of fibrin sealant on the healing colonic anastomosis in the rat

Abstract

Fibrin adhesives have been advocated as a protective seal in colonic anastomosis to prevent leakage. In order to assess the effect of fibrin glue sealing we compared the healing of sutured colonic anastomosis in the rat (group 1) with the addition of human-derived fibrin sealant (group 2). As a control for a possible reaction to foreign protein, in group 3 the sutured anastomosis was sealed with specially prepared rat fibrin adhesive. On days 2, 4 and 7, ten animals in each group were killed. Adhesion formation was scored and the in situ bursting pressure was measured. The collagen concentration and degradation were estimated by measuring hydroxyproline. Adhesion formation was significantly increased in groups 2 and 3 compared with the control group. On days 2 and 7 the bursting pressure was not different between the groups. On day 4 the bursting pressure in groups 2 and 3 was significantly lower than in group 1 (P less than 0.001). These findings correspond with the results of collagen measurements. On day 4 the concentration of hydroxyproline was significantly reduced in groups 2 and 3. Histological examination showed infiltration of neutrophilic granulocytes into the sealant on days 2 and 4; on day 7 the sealant had vanished. From these results it is concluded that fibrin sealing of the colonic anastomosis in the rat does not improve healing, as demonstrated by bursting pressure and hydroxyproline concentration. On the contrary, it seems to have a negative influence.

The Effects of Early Enteral Nutrition Products on the Healing of Colo-Colonic Anastomosis

“…Anastomotic leakage is common after colonic operations because of the bacterial overload of colonic flora [7,8]. The leakage rate in colonic surgery ranges from 4.5% to 50% [9][10][11][12]. Anastomotic leakage may cause peritonitis or intra-abdominal abscesses.…”

Influência da cola Bioglue® na deiscência de anastomose colônica: estudo experimental

“…Podem ser classificados como: adesivos de fibrina, compostos à base de albumina (colas de glutaraldeído), cianoacrilatos (super colas), hidrogéis (polímeros de polietilenoglicóis) e adesivos à base de colágeno (colágeno combinado com fibrina) 34 . Apesar desses estudos, o verdadeiro valor da utilização de adesivos tissulares nas anastomoses colônicas, permanece um assunto controverso, com estudos clínicos prospectivos randomizados ausentes 12,[15][16][17][18][19][20] . A cola a base de albumina-glutaraldeído foi recentemente aprovada para uso em humanos nos EUA como adjuvante em suturas e grampos no reparo de dissecção aórtica aguda.…”

“…Embora algumas dessas inovações técnicas tenham reduzido drasticamente as taxas de deiscência anastomótica, este ainda é um importante problema nos procedimentos cirúrgi-cos sobre o cólon, atingindo cifras de até 5% em cirurgias eletivas e 10-15% em cirurgias de emergência 13,14 . Trabalhos experimentais sobre a utilidade de adesivos tissulares nas anastomoses colônicas são controversos, assim como estudos clínicos prospectivos randomizados são ausentes 12,[15][16][17][18][19][20] . O adesivo cirúrgico BioGlue, formado por dois componentes -albumina sérica bovina purificada e glutaraldeído, forma uma ligação co-valente entre esses dois componentes e as proteínas teciduais no local de aplicação.…”

Effect of intraperitoneal cetuximab administration on colonic anastomosis and early postoperative adhesion formation in a rat model

“…Several parameters were recorded including; integrity of the anastomosis, the existence of perianastomotic abscesses or peritonitis, and adhesion formation. Two independent supervisors evaluated the results depending on the scale of van der Ham et al (12) as follows: 0, no adhesions; 1, minimal adhesions; 2, moderate adhesions; and 3, severe and extensive adhesions, including abscess formation.…”