title: Effects of Ankaferd on anastomotic healing of colon.
abstract: BACKGROUND
  Ankaferd (Ankaferd blood stopper®, ABS) is a recently developed topical hemostatic agent. ABS is a standardized mixture of the plants Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum, and Urtica dioica. Through its effects on the endothelium, blood cells, angiogenesis, cellular proliferation, vascular dynamics, and cell mediators; Ankaferd plays a part in inflammation and hemostasis processes. The aim of this experimental study is to assess the effects of ABS on the left colonic anastomoses under normal, septic, and ischemic conditions.
  
  
  METHODS
  Forty-eight Wistar Albino male rats were divided into six weight-matched equal groups: A, anastomosis in normal condition (n = 8); AA, anastomosis with ABS in normal condition (n = 8); AS, anastomosis in septic condition (n = 8); AAS, anastomosis with ABS in septic condition (n = 8); AI, anastomosis in ischemic condition (n = 8); and AAI, anastomosis with ABS in ischemic condition (n = 8). Blood and tissue samples were taken for the histopathological and biochemical studies after the anastomotic bursting pressures were measured.
  
  
  RESULTS
  Higher hydroxyproline levels (p = .048) and angiogenesis (p = .038) were observed in the sepsis-induced rats compared to the control group. The inflammatory activity, fibrosis, and granulation were comparable in all experimental groups. Ankaferd improved the angiogenesis under septic conditions (AAS) when compared to the control group (AI; p = .038).
  
  
  CONCLUSIONS
  ABS may support anastomotic healing in septic conditions. Topical ABS application controlling the mucosal bleeding at the cut ends of the colon may also improve the anastomotic wound healing by means of increasing mechanical strength and positively affecting angiogenesis. Further studies shall focus on the clinical importance of those findings.
authors.affiliation: 1Department of General Surgery, Cerrahpasa Medical School, Istanbul University , Istanbul , Turkey .
authors.forename: Gulden
authors.initials: G
authors.lastname: Cancan
authors.forename: Serkan
authors.initials: S
authors.lastname: Teksoz
authors.forename: Erman
authors.initials: E
authors.lastname: Aytac
authors.forename: Akif Enes
authors.initials: AE
authors.lastname: Arikan
authors.forename: Hayriye
authors.initials: H
authors.lastname: Erman
authors.forename: Hafize
authors.initials: H
authors.lastname: Uzun
authors.forename: Ferhat
authors.initials: F
authors.lastname: Ozden
authors.forename: Ovgu
authors.initials: O
authors.lastname: Aydin
authors.forename: Murat
authors.initials: M
authors.lastname: Ozcan
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D001696:Biomechanical Phenomena / Q000187:drug effects / Q000502:physiology; D003106:Colon / Q000098:blood supply / Q000503:physiopathology / Q000601:surgery*; D006490:Hemostatics / Q000494:pharmacology*; D008297:Male; D023421:Models, Animal; D018919:Neovascularization, Physiologic / Q000187:drug effects / Q000502:physiology; D010936:Plant Extracts / Q000494:pharmacology*; D051381:Rats; D017208:Rats, Wistar; D018805:Sepsis / Q000503:physiopathology; D014945:Wound Healing / Q000187:drug effects* / Q000502:physiology
chemical_list: D006490:Hemostatics; D010936:Plant Extracts; C539751:ankaferd blood stopper