title: Further experimental studies on a biodegradable adhesive for protection of colorectal anastomosis.
abstract: OBJECTIVE
  Anastomotic leaks (AL) continue to be a devastating complication after colorectal surgery. The purpose of this experimental study was to confirm if Pebisut® applied to intestinal suture lines increases tensile strength in the critical days of healing and to evaluate its anti-inflammatory properties.
  
  
  METHODS
  Bursting pressures and histological evaluation of suture lines in dogs were performed, comparing the burst strength with collagen or fatty tissue patches with/without Pebisut® (patent granted in the USPTO 8,252.333, 26.01.2006, in the European Union 2,062,602, 01.12.2010, in Canada 2,661,686, 21.08.2007 and in Mexico P.C.T./MX/a/2009/001737).
  
  
  RESULTS
  Pebisut® significantly increases burst strength in suture lines in long-term procedures with both collagen and fat pad patches. The adhesive penetrates rapidly into the suture lines, sealing them and progressing towards the intestinal lumen, disappearing in 14-20 days. It was well tolerated without any evidence of "foreign body" reaction.
  
  
  CONCLUSIONS
  Application of the biodegradable adhesive Pebisut® is easy, well tolerated by mammalian tissues and consistently increases the burst strength of suture lines. Therefore, it may provide more tensile strength in anastomosis and help protect AL, one of the most serious complications in gastrointestinal surgery. If this experimental finding could be translated to clinical surgery, the protection of colorectal anastomosis could be beneficial to patients. Additionally, this could also have a positive impact on the economic expenditures of healthcare systems and patients.
authors.affiliation: Health Sciences Faculty, Universidad Anahuac and Hospital Juárez de México S.S., Mexico City, Mexico. Electronic address: cuetoj1@gmail.com.
authors.forename: Jorge
authors.initials: J
authors.lastname: Cueto
authors.affiliation: Health Sciences Faculty, Universidad Anahuac and Hospital Juárez de México S.S., Mexico City, Mexico.
authors.forename: Tomás
authors.initials: T
authors.lastname: Barrientos
authors.affiliation: Health Sciences Faculty, Universidad Anahuac and Hospital Juárez de México S.S., Mexico City, Mexico.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Rodriguez
authors.affiliation: Health Sciences Faculty, Universidad Anahuac and Hospital Juárez de México S.S., Mexico City, Mexico.
authors.forename: Lorena
authors.initials: L
authors.lastname: Espinosa
authors.affiliation: Health Sciences Faculty, Universidad Anahuac and Hospital Juárez de México S.S., Mexico City, Mexico.
authors.forename: Julio
authors.initials: J
authors.lastname: Palma
authors.affiliation: Health Sciences Faculty, Universidad Anahuac and Hospital Juárez de México S.S., Mexico City, Mexico.
authors.forename: Jimmy
authors.initials: J
authors.lastname: Cojab
authors.affiliation: Health Sciences Faculty, Universidad Anahuac and Hospital Juárez de México S.S., Mexico City, Mexico.
authors.forename: Tania
authors.initials: T
authors.lastname: Orozco
authors.affiliation: Health Sciences Faculty, Universidad Anahuac and Hospital Juárez de México S.S., Mexico City, Mexico.
authors.forename: Apolonio
authors.initials: A
authors.lastname: Haro
authors.affiliation: Health Sciences Faculty, Universidad Anahuac and Hospital Juárez de México S.S., Mexico City, Mexico.
authors.forename: Pamela
authors.initials: P
authors.lastname: Del Moral
mesh_terms: D020341:Absorbable Implants; D000273:Adipose Tissue / Q000502:physiology; D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000517:prevention & control*; D000818:Animals; D003094:Collagen / Q000502:physiology; D003106:Colon / Q000601:surgery*; D004285:Dogs; D005260:Female; D008297:Male; D023421:Models, Animal; D011312:Pressure; D012007:Rectum / Q000601:surgery*; D013537:Sutures; D013718:Tensile Strength / Q000187:drug effects; D014014:Tissue Adhesives / Q000494:pharmacology*; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D014014:Tissue Adhesives; D003094:Collagen
keywords: Anastomosis; Bursting pressure; Collagen patch; Leaks; Surgical adhesives