title: Effects of amniotic membrane on the healing of primary colonic anastomoses in the cecal ligation and puncture model of secondary peritonitis in rats.
abstract: OBJECTIVE
  We aimed to investigate the effects of amniotic membrane on primary colonic anastomoses in a rat peritonitis model.
  
  
  METHODS
  Fifty female Sprague Dawley rats were used in the study. Bacterial peritonitis was induced in all rats by performing a cecal ligation and puncture. Ten rats served as controls for the bursting pressure measurement, while the other 40 animals were divided into two groups (the anastomosis group (P) or the amniotic membrane group (PA)), and all of them underwent colonic anastomosis. The latter group had amniotic membrane covering their anastomoses. Half of the PA and P groups were sacrificed on the third postoperative day (PA3, P3), and the other half on the seventh postoperative day (PA7, P7).
  
  
  RESULTS
  The bursting pressures were significantly higher in groups PA3 and PA7 compared with P3 (p < 0.01) and P7 (p < 0.05), respectively. Inflammatory cell infiltration and adhesion scores were significantly lower in groups PA3 and PA7 compared with groups P3 (p < 0.001, p < 0.01, respectively) and P7 (p < 0.001, p < 0.05, respectively). Neoangiogenesis, fibroblast activity, collagen deposition, and hydroxyproline concentrations were significantly higher in groups with amniotic membrane than in groups without amniotic membrane (p < 0.05, for all comparisons).
  
  
  CONCLUSIONS
  This study showed that the covering of colonic anastomoses with amniotic membrane significantly prevented the delaying effect of intraperitoneal sepsis and provided a safer and stronger anastomosis than suture and that this was the case for both the early and late phases of anastomotic healing in the colon.
authors.affiliation: Second Department of General Surgery, Sisli Etfal Training and Research Hospital, Sisli, Istanbul, Turkey. drmuludag@hotmail.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Uludag
authors.forename: Bulent
authors.initials: B
authors.lastname: Citgez
authors.forename: Ozay
authors.initials: O
authors.lastname: Ozkaya
authors.forename: Gurkan
authors.initials: G
authors.lastname: Yetkin
authors.forename: Omer
authors.initials: O
authors.lastname: Ozcan
authors.forename: Nedim
authors.initials: N
authors.lastname: Polat
authors.forename: Adnan
authors.initials: A
authors.lastname: Isgor
mesh_terms: D000650:Amnion; D000714:Anastomosis, Surgical; D000818:Animals; D002432:Cecum / Q000601:surgery*; D003106:Colon / Q000473:pathology / Q000601:surgery*; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D006909:Hydroxyproline / Q000378:metabolism; D008026:Ligation; D010538:Peritonitis / Q000139:chemically induced / Q000601:surgery*; D011312:Pressure; D011677:Punctures; D051381:Rats; D017207:Rats, Sprague-Dawley; D014945:Wound Healing
chemical_list: D006909:Hydroxyproline