The comparison of the suture materials on intestinal anastomotic healing: an experimental study (original) (raw)
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European review for medical and pharmacological sciences, 2013
The aim of this experimental study was to compare the safety of different suture materials in a left colonic anastomosis in the presence of peritonitis. Twenty-one male Wistar albino rats were randomly divided into three groups. First, left colonic injuries were created in all groups for the peritonitis model. After 24 hours, coated polyglactin 910 and silk suture were used in Group I rats, polydioxanone and silk suture were used in Group II rats, and coated polyglactin 910 plus antibacterial suture and silk suture were used in Group III rats during colonic anastomosis. Tissue hydroxyproline, anastomotic bursting pressure, and histopathologic findings on the anastomosis line were evaluated on the 10th postoperative day by performing a relaparatomy. The mean bursting pressure values were 198 ± 11.37, 220 ± 17.7, and 244 ± 9.52 in Groups I, II, and III, respectively (Group I vs. II, p < 0.035; I vs III, p < 0.002; and II vs III, p < 0.021). The mean hydroxyproline levels were...
International Journal of Surgery, 2011
Introduction: Anastomotic dehiscence remains an important challenge for colorectal surgeons worldwide. Extensive research focused on performing a safe anastomosis is conducted with rats being the most used model when examining colorectal anastomoses. In daily clinical practice resorbable sutures are used when hand-sewn anastomoses are performed. However, in the experimental studies examining colorectal anastomoses, non-resorbable sutures have predominantly been used. The aim of this study was to compare a rapidly resorbable suture with a non-resorbable suture in experimental colorectal anastomoses. Methods: This was an experimental, prospective, case-control study using forty male Wistar rats. A colonic anastomosis was performed in a standardized fashion with either rapidly resorbable or nonresorbable suture. On the seventh postoperative day, the animals were sacrificed and the breaking strength of the anastomoses was measured. Results: No suffering or poor wellbeing of the animals was registered. No animals died or were prematurely sacrificed. At tissue harvesting, no anastomotic leaks or signs of peritonitis were registered. The breaking strengths of the anastomoses were comparable in the two groups (median 2.175 (range 1.479e2.880) Newton vs. 2.267 (1.290e4.042) Newton (P ¼ 0.256) for resorbable and non-resorbable sutures, respectively). We found no significant correlations between pre-to postoperative weight-loss and anastomotic strength. Conclusion: Non-resorbable suture was comparable with rapidly resorbable suture with regards to breaking strength of an experimental colonic anastomosis. Thus, absorbable suture can be used in experimental studies which then more easily can be compared to clinical practice.
Techniques in Coloproctology, 2011
Background The aim of the study was to compare the degree of healing and air tightness of hand-sewn colonic anastomoses provided by different biological glues. Methods Thirty colonic anastomoses were fashioned in ten rabbits, at 5, 10, 15 cm from the ileocecal valve, with 4/0 PDS running sutures. Each suture was randomized to treatment with fibrin sealant (Tissucol®), a synthetic glue (Coseal®), or
Effect of oxygen‐producing suture material on hypoxic colonic anastomoses in an experimental model
BJS Open, 2019
Background: Anastomotic leak remains a significant cause of morbidity and mortality after colorectal surgery. Among multiple risk factors considered, hypoxia-ischaemia is considered to be a primary cause of intestinal anastomotic leakage. The aim of this experimental study was to assess safety, usability for surgical tasks, and efficacy of a newly developed oxygen-producing suture material in the healing of colonic anastomoses under critical conditions. Methods: An oxygen-producing suture material was produced that is capable of releasing oxygen directly into the surrounding tissue. Off-the-shelf sutures loaded with calcium peroxide nano-crystals and covered with poly(D,L-lactide-co-glycolide) were assessed in vitro and in a rat model of hypoxic colonic anastomosis. Results: In vitro assessment showed that these sutures can increase oxygen levels in a hypoxic environment. Potential oxygen byproducts did not seem to have a negative impact on the viability of intestinal cells. The use of oxygen-producing sutures in vivo resulted in increased tissue oxygen saturation, measured by visible light spectroscopy, and increased mechanical stability of the anastomosis. Conclusion: Oxygen-producing suture material increased tissue oxygen saturation and mechanical stability of colonic anastomosis in a rat model. Surgical relevance Leakage of anastomoses remains a significant problem after colorectal surgery. An oxygen-producing suture material was produced that was shown to be safe in vitro and significantly improved several aspects of healing of colonic anastomoses in an animal model. Oxygen-producing suture material or stapler devices might help to reduce the risk of anastomotic leak of intestinal anastomoses under physiological and critical conditions such as hypoxia.
The American Journal of Surgery, 2004
Background: Tissue adhesives may be advantageous over sutures in colonic anastomoses because they do not result in potentially dangerous tight tissue approximation. Methods: Ninety male Wistar-albino rats were used in the study. Excluding the 10 animals that constituted the control, the rest of the animals were divided in two groups: normal (N) and high-risk (HR). Only resection and anastomosis were done on half of the animals in each group. Octyl-cyanoacrylate was applied on the anastomosis of the other half of the groups. Anastomotic assessment was done at the third and seventh postoperative days. Gross anastomotic healing, mechanical strength, hydroxyproline deposition, and histopathological healing indices were used for the assessment. Results: There was no difference in the third day and the seventh day groups regarding the gross healing parameters and hydroxyproline concentration. Similarly there was no difference between the third day groups in terms of mechanical healing (P ϭ 0.669). However, the mechanical strength of the anastomosis assessed the seventh postoperative day was lower in groups in which octyl-cyanoacrylate was applied (P Ͻ0.001). Furthermore, inflammatory reaction, presence of necrosis, peritonitis, and exudate was pronounced in groups in which octyl-cyanoacrylate was applied. Conclusions: Application of octyl-cyanoacrylate to both normal and high-risk colonic anastomosis does not provide any benefit over conventional suturing at the early phase of the healing. However, octyl-cyanoacrylate seems to be detrimental at the late phase of the healing probably due to the ongoing intense inflammatory reaction.
A New Biodegradable Adhesive for Protection of Intestinal Anastomoses. Preliminary Communication
Background and Aims. Anastomotic leaks continue to be a devastating complication for patients and surgeons worldwide. The few surgical adhesives available to date have not achieved the desired clinical results. The purpose of this experimental study was to determine if Pebisut Ò applied to intestinal suture lines provides increased resistance and protection during the critical days of healing. Methods. Intestinal lesions were caused in rats and dogs and a new biodegradable adhesive (Pebisut Ò) (patent granted in the European Union 07808494.4-1219, 01.12.2010, in Mexico P.C.T./MX/a/2009/001737, 16.02.2009, pending in the U.S.P.T.O. 60/762,136, 26.01.2006) was applied to compare the resistance of suture lines using bursting pressures and histologically. Results. Under acute and chronic conditions, Pebisut Ò strengthened and made the suture lines more resistant, while histologically penetrating and sealing them. The adhesive disappears within 2e3 weeks and is well tolerated by the intestinal tissues. Conclusions. This biodegradable adhesive provides greater resistance, temporarily protects suture lines and may prevent anastomotic leaks. Ó 2011 IMSS. Published by Elsevier Inc.
Different Surgical Methods in Colon Anastomosis: Experimental Study
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
- BACKGROUND: Although many methods have been defined for colonic anastomosis, anastomotic leak still remains important for sepsis control and successful healing. AIM: The purpose of this study was to compare the effects of conventional suture, polyglactin 910 mesh, and omental flap coverage on healing and anastomotic leak in experimental colonic anastomosis in rats. METHOD: This study was conducted on 18 Wistar rats and the animals were divided into three groups as follows: Group 1: primary suture group; Group 2: primary suture plus polyglactin 910 mesh group; and Group 3: primary suture plus omental flap coverage group. Groups were compared in terms of anastomotic bursting pressure, inflammation, fibroblastic activity, neovascularization, and collagen amount. RESULTS: There was a statistically significant difference in anastomotic bursting pressure between Groups 1 and 2 and between Groups 1 and 3 (p=0.004, p<0.05). There was a significant difference in fibroblastic activity be...
Doxycycline-coated sutures improve mechanical strength of intestinal anastomoses
2008
Background and aims: After resection and repair of the intestines, tissue degradation leads to weakening of the repair site and a risk of postoperative leakage. Matrix metalloproteinases (MMPs) are thought to be responsible for collagenolysis in the direct vicinity of surgical sutures in many tissues. Several experimental studies show that MMP-inhibitors administered systemically alleviate postoperative weakening of intestinal anastomoses. We hypothesised that local delivery of MMP-inhibitors would achieve a similar effect. Methods: Implementing a novel method for the coating of biomaterials, we coated sutures with a crosslinked fibrinogen film and bound the MMP-inhibitor doxycycline into this film. The sutures were then used in a standard rat model for evaluating mechanical properties of colonic anastomoses 3 days after surgery. Results: The breaking strength of the anastomoses on the critical third day after operation was 17 % higher with doxycycline-coated sutures compared to controls (P=0.026). Energy uptake at failure was enhanced by 20 % (P=0.047). Conclusion: Drug delivery by means of MMP-inhibitor-coated sutures appears to improve tissue integrity during anastomotic repair and may reduce postoperative complications.
The effect of chitosan coating on surgical sutures to strengthen the colonic anastomosis
Turkish journal of trauma & emergency surgery, 2018
BACKGROUND: We evaluated the feasibility of chitosan-coated sutures for intestinal anastomosis strength through wound-healing effect. METHODS: Vicryl and PDS sutures were coated with 2% chitosan. While laparotomy was applied to the first group, chitosan was applied in the peritoneal cavity in the second group. Then the following materials were applied to colon anastomosis, in order: Vicryl, PDS, chitosan-coated Vicryl, and chitosan-coated PDS sutures. On the 7 th and 14 th days, eight rats from each group were euthanized. RESULTS: The adhesion scores of chitosan and control groups were lower than the suture groups. The vascularization of Vicryl-chitosan was lower than PDS-chitosan on the 14 th day (p=0.038). Fibroblast cells and vascularization of anastomosis with chitosan-coated Vicryl were lower than Vicryl and chitosan-coated PDS on the 14th day (p<0.05). The tensile strength of Vicryl-chitosan increased more than Vicryl in vitro (p<0.05) on the 14 th and 7 th days, but there was no difference in vivo. The tensile strength of PDS-chitosan decreased more than PDS on the 7 th day in vivo (p<0.05). CONCLUSION: The chitosan-coating effect on the adhesion and reinforcement of anastomosis in some parts of Vicryl in vitro and PDS in vivo was slightly improved.