Simvastatin improves wound strength after intestinal anastomosis in the rat.
BACKGROUND
Simvastatin is a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor commonly known as a cholesterol-lowering drug with additional pleiotropic effects. Also, it is demonstrated that it prevents postoperative peritoneal adhesions in rat. This study was designed to assess its effects on the healing process of colonic anastomosis.


METHODS
Thirty-two male Wistar albino rats were randomized into two groups and subjected to colonic anastomosis. The study group was treated with simvastatin and the control group received only tap water instead. The rats were killed 3 and 7 days postoperatively. Wound complications, intra-abdominal abscesses, and anastomotic leaks and stenosis were recorded. Four types of assessment were performed: bursting pressure, hydroxyproline content, histopathology, and biochemical analysis.


RESULTS
Compared to the control group, simvastatin-treated rats displayed a higher bursting pressure (p < 0.001) and anastomotic hydroxyproline content (p < 0.05). Simvastatin treatment leads to a significant decrease in malondealdehyde levels (p < 0.05) and increase in paraoxonase activity (p < 0.001) at both time points. Histopathological analysis revealed that simvastatin administration leads to a better anastomotic healing in terms of reepithelialization, decreased granuloma formation, reduced ischemic necrosis, and inflammatory infiltration to muscle layer.


CONCLUSIONS
Clinically relevant doses of simvastatin do not have a negative impact on colonic anastomosis but improve intestinal wound healing in rats.
Karadeniz Cakmak
G
G
Department of Surgery, The School of Medicine, Zonguldak Karaelmas University, Kozlu-Zonguldak, Turkey. gkkaradeniz@yahoo.com
Irkorucu
O
O
Ucan
B H
BH
Emre
A U
AU
Bahadir
B
B
Demirtas
C
C
Tascilar
O
O
Karakaya
K
K
Acikgoz
S
S
Kertis
G
G
Ankarali
H
H
Pasaoglu
H
H
Comert
M
M
D000704:Analysis of Variance; D000714:Anastomosis, Surgical; D000818:Animals; D003082:Colectomy / Q000379:methods*; D003094:Collagen / Q000378:metabolism; D019245:Compressive Strength / Q000187:drug effects* / Q000502:physiology; D004195:Disease Models, Animal; D007150:Immunohistochemistry; D007422:Intestines / Q000187:drug effects* / Q000473:pathology; D008297:Male; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D012016:Reference Values; D019821:Simvastatin / Q000494:pharmacology*; D014945:Wound Healing / Q000187:drug effects*
D003094:Collagen; D019821:Simvastatin