Fibrin glue improves the healing of irradiated bowel anastomoses.
Many surgeons are reluctant to construct a bowel anastomosis with irradiated intestine. Previous studies have demonstrated diminished tensile strength of rat small bowel anastomoses that have been irradiated intraoperatively. To determine whether fibrin glue, a known tissue adhesive, improves the healing of these anastomoses, 69 male Sprague-Dawley rats were randomized into three anastomotic groups: Group 1, sutured ileal anastomosis without radiation or fibrin glue; Group 2, irradiated sutured ileal anastomosis without fibrin glue; and Group 3, irradiated ileal anastomosis with fibrin glue added to the suture line. Groups 2 and 3 received a single dose of 2,000 R intraoperatively. At seven days, the rats were sacrificed and the anastomotic segment was tested for breaking (tensile) strength. Anastomotic collagen content was evaluated using a hydroxyproline assay. Tensile strength results demonstrated that Group 2 was significantly weaker than Groups 1 and 3 (P = 0.001) and that the hydroxyproline content of Group 3 was significantly greater than that of Group 2 (P = 0.015). These results show that the addition of fibrin glue to an intraoperatively irradiated small bowel anastomosis improves healing, as demonstrated by both tensile strength and hydroxyproline content studies.
Saclarides
T J
TJ
Department of General Surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612.
Woodard
D O
DO
Bapna
M
M
Economou
S G
SG
D000714:Anastomosis, Surgical; D000818:Animals; D015718:Fibrin Tissue Adhesive / Q000494:pharmacology*; D006801:Humans; D006909:Hydroxyproline / Q000378:metabolism; D007082:Ileum / Q000187:drug effects / Q000378:metabolism / Q000528:radiation effects / Q000601:surgery*; D008297:Male; D011897:Random Allocation; D051381:Rats; D011919:Rats, Inbred Strains; D013718:Tensile Strength; D014945:Wound Healing / Q000187:drug effects* / Q000528:radiation effects*
D015718:Fibrin Tissue Adhesive; D006909:Hydroxyproline