Fibrinogen and thrombin concentrations are critical for fibrin glue adherence in rat high-risk colon anastomoses

Abstract

OBJECTIVE:Fibrin glues have not been consistently successful in preventing the dehiscence of high-risk colonic anastomoses. Fibrinogen and thrombin concentrations in glues determine their ability to function as sealants, healers, and/or adhesives. The objective of the current study was to compare the effects of different concentrations of fibrinogen and thrombin on bursting pressure, leaks, dehiscence, and morphology of high-risk ischemic colonic anastomoses using fibrin glue in rats.METHODS:Colonic anastomoses in adult female Sprague-Dawley rats (weight, 250-350 g) treated with fibrin glue containing different concentrations of fibrinogen and thrombin were evaluated at post-operative day 5. The interventions were low-risk (normal) or high-risk (ischemic) end-to-end colonic anastomoses using polypropylene sutures and topical application of fibrinogen at high (120 mg/mL) or low (40 mg/mL) concentrations and thrombin at high (1000 IU/mL) or low (500 IU/mL) concentrations.RESULTS:Ischemia alone, anastomosis alone, or both together reduced the bursting pressure. Glues containing a low fibrinogen concentration improved this parameter in all cases. High thrombin in combination with low fibrinogen also improved adherence exclusively in low-risk anastomoses. No differences were detected with respect to macroscopic parameters, histopathology, or hydroxyproline content at 5 days post-anastomosis.CONCLUSIONS:Fibrin glue with a low fibrinogen content normalizes the bursting pressure of high-risk ischemic left-colon anastomoses in rats at day 5 after surgery.

Effect of Peritoneum Graft on Intestinal Anastomosis Healing After Deserosalization in Dogs

“…The Bp value among the peritoneal graft-coated group and control group at 15 th days post-operation was significantly different, which indicates that the coating of the injured site of the anastomosis with peritoneal graft increased the strength of the anastomotic site. These results are in agreement with others who reported a significant increase in strength and Bp of the anastomotic area after reinforcing with tissue graft [28,34,35]. However, there were differences in Bp between the 7 th and 15 th days groups but this difference was not significant.…”

“…Also, in another study, the deserosalization in the anastomosis site resulted in improved mechanical strength and collagen deposition [12]. While in rats, it has been suggested that the abrasion of the serosal layer of intestinal edges and anastomosed by inverted technique does not reduce leakage and did not increase the mechanical strength of the anastomotic site [28]. Therefore, we designed this experiment to study the effect of peritoneal graft in decreasing the complication of deserosalization.…”

In vivo evaluation of Mg–6Zn and titanium alloys on collagen metabolism in the healing of intestinal anastomosis

“…A variety of inflammatory cells, wound repair cells, extracellular matrices (ECMs) and cytokines participate in the process of healing. Collagenous fibers that exist in mucosa, submucosa and serosa, act as biomechanical fixed points, and are particularly important in the healing of anastomosis 22 23 24 25 . Collagen I contribute to the formation of mature scar tissue, which is mainly responsible for the mechanical tissue stability, whereas collagen III is always found mainly during the early phases of wound healing 26 .…”

A Novel Fibrin Matrix Derived from Platelet-Rich Plasma: Protocol and Characterization

“…In addition, the often-poor adhesion of these matrices, which can be compromised by their low fibrinogen concentration [15], also limits their application when prolonged adhesion of the clot to the tissue is required. Thus, commercial sealants based on these products vary in their proportions of thrombin and fibrinogen so as to modify product adhesion [16].…”