title: The effect of fibrin glue on the early healing phase of intestinal anastomoses in the rat.
abstract: OBJECTIVE
  Protecting the anastomotic integrity using suture or staple line reinforcement remains an important goal for ongoing research. The present comprehensive study aims to establish the effects of fibrin glue on the early phase of anastomotic healing in the rat intestine.
  
  
  METHODS
  One hundred and eight young adult male Wistar rats underwent resection and anastomosis of both the ileum and colon. In half, fibrin glue was applied around the anastomoses. Parameters for repair included wound strength, both bursting pressure and breaking strength at days 1, 3, and 5 after operation; hydroxyproline content; and histology, the latter also after 7 days.
  
  
  RESULTS
  A transient colonic ileus was observed in the experimental group. Anastomotic breaking strength was always similar in both the control and fibrin glue groups. Anastomotic bursting pressures remained low at days 1 and 3, without any differences between the groups. In both groups, the bursting pressure increased sharply (p < 0.001) between days 3 and 5. At day 5, the bursting pressure in the fibrin glue group remained below than that in the controls, although only significantly (p = 0.0138) so in the ileum. At day 5, but not at day 7, the wounds in the fibrin glue group contained less collagen. Other aspects of microscopic wound architecture appeared to be the same.
  
  
  CONCLUSIONS
  There is no justification for using fibrin glue on patent anastomoses constructed under low-risk conditions. Its potential benefit under conditions where chances for anastomotic leakage are enhanced needs further investigation.
authors.affiliation: Department of Surgery, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands. r.vandervijver@chir.umcn.nl
authors.forename: Rozemarijn J
authors.initials: RJ
authors.lastname: van der Vijver
authors.forename: Cees J H M
authors.initials: CJ
authors.lastname: van Laarhoven
authors.forename: Ben M
authors.initials: BM
authors.lastname: de Man
authors.forename: Roger M L M
authors.initials: RM
authors.lastname: Lomme
authors.forename: Thijs
authors.initials: T
authors.lastname: Hendriks
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D001835:Body Weight / Q000187:drug effects; D003094:Collagen / Q000378:metabolism; D003106:Colon / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D015718:Fibrin Tissue Adhesive / Q000494:pharmacology*; D006909:Hydroxyproline / Q000378:metabolism; D007422:Intestines / Q000187:drug effects* / Q000473:pathology / Q000601:surgery*; D008297:Male; D011182:Postoperative Care; D059748:Proteolysis / Q000187:drug effects; D051381:Rats; D017208:Rats, Wistar; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D015718:Fibrin Tissue Adhesive; D003094:Collagen; D006909:Hydroxyproline