title: Impact of remote ischemic preconditioning on wound healing in small bowel anastomoses.
abstract: OBJECTIVE
  To investigate the influence of remote ischemic preconditioning (RIPC) on anastomotic integrity.
  
  
  METHODS
  Sixty male Wistar rats were randomized to six groups. The control group (n = 10) had an end-to-end ileal anastomosis without RIPC. The preconditioned groups (n = 34) varied in time of ischemia and time of reperfusion. One group received the amino acid L-arginine before constructing the anastomosis (n = 9). On postoperative day 4, the rats were re-laparotomized, and bursting pressure, hydroxyproline concentration, intra-abdominal adhesions, and a histological score concerning the mucosal ischemic injury were collected. The data are given as median (range).
  
  
  RESULTS
  On postoperative day 4, median bursting pressure was 124 mmHg (60-146 mmHg) in the control group. The experimental groups did not show a statistically significant difference (P > 0.05). Regarding the hydroxyproline concentration, we did not find any significant variation in the experimental groups. We detected significantly less mucosal injury in the RIPC groups. Furthermore, we assessed more extensive intra-abdominal adhesions in the preconditioned groups than in the control group.
  
  
  CONCLUSIONS
  RIPC directly before performing small bowel anastomosis does not affect anastomotic stability in the early period, as seen in ischemic preconditioning.
authors: Department of General and Visceral Surgery, Albert Ludwigs University of Freiburg, Freiburg 79106, Germany. philipp.holzner@uniklinik-freiburg.de
authors: Philipp Anton
authors: PA
authors: Holzner
authors: Birte
authors: B
authors: Kulemann
authors: Simon
authors: S
authors: Kuesters
authors: Sylvia
authors: S
authors: Timme
authors: Jens
authors: J
authors: Hoeppner
authors: Ulrich Theodor
authors: UT
authors: Hopt
authors: Goran
authors: G
authors: Marjanovic
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D001120:Arginine / Q000378:metabolism; D006909:Hydroxyproline / Q000096:biosynthesis / Q000378:metabolism; D007421:Intestine, Small / Q000473:pathology*; D019194:Ischemic Preconditioning / Q000379:methods*; D007813:Laparotomy; D008297:Male; D009092:Mucous Membrane / Q000473:pathology; D011312:Pressure; D051381:Rats; D017208:Rats, Wistar; D000267:Tissue Adhesions; D014945:Wound Healing
chemical_list: D001120:Arginine; D006909:Hydroxyproline