The effects of local and sustained release of fibroblast growth factor on wound healing in esophageal anastomoses.
OBJECTIVE
Postsurgical complications, such as anastomotic leaks in patients with esophageal atresia, have remained unchanged during the last 3 decades. Growth factors enhance healing in several wound-healing models. Therefore, an experimental study was used to evaluate the effects of local and sustained release of basic fibroblast growth factor (FGF) on wound healing in esophageal anastomoses.


METHODS
Twenty-four male Wistar albino rats, which were subjected to a 1-cm segmental resection of the abdominal esophagus followed by end-to-end anastomosis, were allocated into 3 groups. Group I, the control group, had no gelatin film applied to the anastomosis. In group II (gelatin film without FGF) and group III (gelatin film with FGF), anastomoses were covered with unloaded and 2.55 mug FGF-loaded gelatin films, respectively. On postoperative day 7, bursting pressures, histopathologic collagen deposition, and tissue hydroxyproline concentrations of the anastomoses were then analyzed and compared.


RESULTS
Mean bursting pressures, mean submucosal and muscular collagen deposition scores, and mean tissue hydroxyproline concentrations differed significantly between groups. Mean bursting pressures were 22.5 +/- 3.1 mm Hg in group I, 29 +/- 1.6 mm Hg in group II, and 63.2 +/- 6.8 mm Hg in group III (P < .001). Mean submucosal collagen deposition scores (group I: 0.7 +/- 0.2, group II: 0.7 +/- 0.1, group III: 1.5 +/- 0.2; P = .02) and mean muscular collagen deposition scores (group I: 0.8 +/- 0.2, group II: 0.8 +/- 0.1, group III: 1.8 +/- 0.1; P = .01) were significantly higher in FGF animals than the other in the other 2 groups. Mean tissue hydroxyproline concentrations were 2.4 +/- 0.5 microg/mg in group I, 3.9 +/- 0.4 microg/mg in group II, and 6.0 +/- 1.0 microg/mg in group III (P = .007).


CONCLUSIONS
Local and sustained release of FGF enhanced wound healing in esophageal anastomoses in this animal model.
Fedakar-Senyucel
Mine
M
Department of Pediatric Surgery, School of Medicine, Ankara University, 06100 Ankara, Turkey.
Bingol-Kologlu
Meltem
M
Vargun
Rahsan
R
Akbay
Canan
C
Sarac
F Nurşen
FN
Renda
Nurten
N
Hasirci
Nesrin
N
Gollu
Gulnur
G
Dindar
Huseyin
H
D000704:Analysis of Variance; D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D003692:Delayed-Action Preparations; D004195:Disease Models, Animal; D016503:Drug Delivery Systems; D004933:Esophageal Atresia / Q000601:surgery*; D005346:Fibroblast Growth Factors / Q000008:administration & dosage*; D008297:Male; D011336:Probability; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D012016:Reference Values; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013718:Tensile Strength; D014945:Wound Healing / Q000187:drug effects*
D003692:Delayed-Action Preparations; D005346:Fibroblast Growth Factors