Fibrinogen and thrombin concentrations are critical for fibrin glue adherence in rat high-risk colon anastomoses.
OBJECTIVE
Fibrin glues have not been consistently successful in preventing the dehiscence of high-risk colonic anastomoses. Fibrinogen and thrombin concentrations in glues determine their ability to function as sealants, healers, and/or adhesives. The objective of the current study was to compare the effects of different concentrations of fibrinogen and thrombin on bursting pressure, leaks, dehiscence, and morphology of high-risk ischemic colonic anastomoses using fibrin glue in rats.


METHODS
Colonic anastomoses in adult female Sprague-Dawley rats (weight, 250-350 g) treated with fibrin glue containing different concentrations of fibrinogen and thrombin were evaluated at post-operative day 5. The interventions were low-risk (normal) or high-risk (ischemic) end-to-end colonic anastomoses using polypropylene sutures and topical application of fibrinogen at high (120 mg/mL) or low (40 mg/mL) concentrations and thrombin at high (1000 IU/mL) or low (500 IU/mL) concentrations.


RESULTS
Ischemia alone, anastomosis alone, or both together reduced the bursting pressure. Glues containing a low fibrinogen concentration improved this parameter in all cases. High thrombin in combination with low fibrinogen also improved adherence exclusively in low-risk anastomoses. No differences were detected with respect to macroscopic parameters, histopathology, or hydroxyproline content at 5 days post-anastomosis.


CONCLUSIONS
Fibrin glue with a low fibrinogen content normalizes the bursting pressure of high-risk ischemic left-colon anastomoses in rats at day 5 after surgery.
Centro de Investigación Biomédica de Occidente, IMSS, Surgical Research Division, Guadalajara, Jal, México.
Eliseo
E
Portilla-de Buen
Transplantation Department, SSG, Hospital Regional de Alta Especialidad del Bajío, León, Gto, México.
Abel
A
Orozco-Mosqueda
Centro de Investigación Biomédica de Occidente, IMSS, Surgical Research Division, Guadalajara, Jal, México.
Caridad
C
Leal-Cortés
Cell Biology Laboratory, Instituto Tecnológico de Estudios Superiores de Monterrey, School of Medicine, Campus Guadalajara, Jal, México.
Gonzalo
G
Vázquez-Camacho
Surgical Section of the Research Unit in Clinical Epidemiology, CMNO, IMSS, Hospital de Especialidades, Guadalajara, Jal, México.
Clotilde
C
Fuentes-Orozco
Medical Care Services, IMSS, Baja California Sur, México.
Andrea Socorro
AS
Alvarez-Villaseñor
Surgical Section of the Research Unit in Clinical Epidemiology, CMNO, IMSS, Hospital de Especialidades, Guadalajara, Jal, México.
Michel Dassaejv
MD
Macías-Amezcua
Surgical Section of the Research Unit in Clinical Epidemiology, CMNO, IMSS, Hospital de Especialidades, Guadalajara, Jal, México.
Alejandro
A
González-Ojeda
D000714:Anastomosis, Surgical; D000818:Animals; D003094:Collagen / Q000032:analysis; D003106:Colon / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005340:Fibrinogen / Q000008:administration & dosage*; D006909:Hydroxyproline / Q000032:analysis; D007511:Ischemia / Q000209:etiology / Q000517:prevention & control*; D011312:Pressure; D017207:Rats, Sprague-Dawley; D015203:Reproducibility of Results; D012307:Risk Factors; D013917:Thrombin / Q000008:administration & dosage*; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome; D014945:Wound Healing
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D005340:Fibrinogen; D003094:Collagen; D013917:Thrombin; D006909:Hydroxyproline