Bovine pericardium patch wrapping intestinal anastomosis improves healing process and prevents leakage in a pig model.
Failure of intestinal anastomosis is a major complication following abdominal surgery. Biological materials have been introduced as reinforcement of abdominal wall hernia in contaminated setting. An innovative application of biological patch is its use as reinforcement of gastrointestinal anastomosis. The aim of study was to verify whether the bovine pericardium patch improves the healing of anastomosis, when in vivo wrapping the suture line of pig intestinal anastomosis, avoiding leakage in the event of deliberately incomplete suture. Forty-three pigs were randomly divided: Group 1 (control, n = 14): hand-sewn ileo-ileal and colo-colic anastomosis; Group 2 (n = 14): standard anastomosis wrapped by pericardium bovine patch; Group 3 (n = 1) and 4 (n = 14): one suture was deliberately incomplete and also wrapped by patch in the last one. Intraoperative evaluation, histological, biochemical, tensiometric and electrophysiological studies of intestinal specimens were performed at 48 h, 7 and 90 days after. In groups 2 and 4, no leak, stenosis, abscess, peritonitis, mesh displacement or shrinkage were found and adhesion rate decreased compared to control. Biochemical studies showed mitochondrial function improvement in colic wrapped anastomosis. Tensiometric evaluations suggested that the patch preserves the colic contractility similar to the controls. Electrophysiological results demonstrated that the patch also improves the mucosal function restoring almost normal transport properties. Use of pericardium bovine patch as reinforcement of intestinal anastomosis is safe and effective, significantly improving the healing process. Data of prevention of acute peritonitis and leakage in cases of iatrogenic perforation of anastomoses, covered with patch, is unpublished.
Department of Biomedical Sciences and Human Oncology, Unit of Endocrine, Digestive and Emergency Surgery, University Medical School "A. Moro", Bari, Italy.
Mario
M
Testini
Department of Biomedical Sciences and Human Oncology, Unit of Endocrine, Digestive and Emergency Surgery, University Medical School "A. Moro", Bari, Italy.
Angela
A
Gurrado
Department of Biomedical Sciences and Human Oncology, Unit of Medicine "A. Murri", University Medical School "A. Moro", Bari, Italy.
Piero
P
Portincasa
Department Basic Medical Sciences, University Medical School "A. Moro", Bari, Italy.
Salvatore
S
Scacco
Department of Emergency Surgery and Organ Transplantation, Unit of Pathology, University Medical School "A. Moro", Bari, Italy.
Andrea
A
Marzullo
Department of Biomedical Sciences and Human Oncology, Unit of Endocrine, Digestive and Emergency Surgery, University Medical School "A. Moro", Bari, Italy.
Giuseppe
G
Piccinni
Department of Biomedical Sciences and Human Oncology, Unit of Endocrine, Digestive and Emergency Surgery, University Medical School "A. Moro", Bari, Italy.
Germana
G
Lissidini
Department of Emergency Surgery and Organ Transplantation, Unit of General Surgery and Liver Transplantation, University Medical School "A. Moro", Bari, Italy.
Luigi
L
Greco
Department of Biomedical Sciences and Human Oncology, Section of Pharmachology, University Medical School "A. Moro", Bari, Italy.
Maria Antonietta
MA
De Salvia
Department of Biomedical Sciences and Human Oncology, Unit of Medicine "A. Murri", University Medical School "A. Moro", Bari, Italy.
Leonilde
L
Bonfrate
Department of Biosciences, Biotechnology and Pharmacological Sciences, University Medical School "A. Moro", Bari, Italy.
Lucantonio
L
Debellis
Department Basic Medical Sciences, University Medical School "A. Moro", Bari, Italy.
Nicola
N
Sardaro
Department of Emergency Surgery and Organ Transplantation, Division of Veterinary Clinics and Animal Productions, University Medical School "A. Moro", Bari, Italy.
Francesco
F
Staffieri
Department of Biomedical Sciences and Human Oncology, Section of Pharmachology, University Medical School "A. Moro", Bari, Italy.
Maria Rosaria
MR
Carratù
Department of Emergency Surgery and Organ Transplantation, Division of Veterinary Clinics and Animal Productions, University Medical School "A. Moro", Bari, Italy.
Antonio
A
Crovace
D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D002417:Cattle; D003106:Colon / Q000601:surgery*; D005260:Female; D007082:Ileum / Q000601:surgery*; D010496:Pericardium / Q000637:transplantation*; D010528:Peristalsis / Q000502:physiology; D010538:Peritonitis / Q000517:prevention & control*; D020127:Recovery of Function / Q000502:physiology; D013524:Surgical Flaps / Q000637:transplantation*; D013526:Surgical Mesh; D013537:Sutures; D013552:Swine; D014183:Transplantation, Heterologous; D014945:Wound Healing