Effects of amniotic membrane on the healing of primary colonic anastomoses in the cecal ligation and puncture model of secondary peritonitis in rats.
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.
Uludag
Mehmet
M
Second Department of General Surgery, Sisli Etfal Training and Research Hospital, Sisli, Istanbul, Turkey. drmuludag@hotmail.com
Citgez
Bulent
B
Ozkaya
Ozay
O
Yetkin
Gurkan
G
Ozcan
Omer
O
Polat
Nedim
N
Isgor
Adnan
A
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
D006909:Hydroxyproline