Effects of diclofenac sodium on intestinal anastomotic healing. Experimental study on the small intestine of rabbits.
To study the possible effects of diclofenac sodium on intestinal anastomoses, 48 rabbits were submitted to surgery consisting of two single-layer ileal anastomoses performed with separate propylene 5-0 sutures. The animals were divided at random into two groups (test and control). The animals in the test group were given intramuscular injections of diclofenac sodium at the dose of 3 mg/kg body weight at 24-hour intervals, and the control animals were given injections of an identical amount of 0.9 percent saline. The animals were sacrificed on the 3rd, 7th, and 14th postoperative days for macroscopic evaluation of the peritoneal cavity and of the anastomoses, tensile strength measurement, hydroxyproline determination, and histopathologic examination. The following results were observed: anastomotic dehiscence followed by peritonitis and death in five test animals (20.83 percent) and no control animals; decreased anastomotic tensile strength on the 7th day in test animals (P less than 0.05); delayed acute inflammatory response and onset of fibroblast proliferation in the test group; and similar hydroxyproline levels in both groups. On the basis of the results obtained, we conclude that diclofenac sodium had a negative effect on intestinal anastomotic healing.
de Sousa
J B
JB
Department of Surgery, Orthopedics and Traumatology, University Hospital, Faculty of Medicine of Ribeirào Preto, University of São Paulo, Brazil.
Soares
E G
EG
Aprilli
F
F
D000714:Anastomosis, Surgical; D000818:Animals; D004008:Diclofenac / Q000633:toxicity*; D005260:Female; D006909:Hydroxyproline / Q000187:drug effects; D007421:Intestine, Small / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D011817:Rabbits; D011897:Random Allocation; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013718:Tensile Strength / Q000187:drug effects; D014945:Wound Healing / Q000187:drug effects*
D004008:Diclofenac; D006909:Hydroxyproline