title: The effect of tissue adhesive, octyl-cyanoacrylate, on the healing of experimental high-risk and normal colonic anastomoses.
abstract: 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 = 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 <0.001). 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.
authors.affiliation: Department of General Surgery, Adana Teaching and Research Center, Başkent University, Adana, Turkey. tznursal@hotmail.com
authors.forename: Tarik Zafer
authors.initials: TZ
authors.lastname: Nursal
authors.forename: Rüksan
authors.initials: R
authors.lastname: Anarat
authors.forename: Sema
authors.initials: S
authors.lastname: Bircan
authors.forename: Sedat
authors.initials: S
authors.lastname: Yildirim
authors.forename: Akin
authors.initials: A
authors.lastname: Tarim
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D003106:Colon / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D003487:Cyanoacrylates; D006909:Hydroxyproline / Q000378:metabolism; D008297:Male; D051381:Rats; D017208:Rats, Wistar; D012307:Risk Factors; D014014:Tissue Adhesives; D014945:Wound Healing
chemical_list: D003487:Cyanoacrylates; D014014:Tissue Adhesives; C100832:octyl 2-cyanoacrylate; D006909:Hydroxyproline