title: The use of TachoSil as sealant in an experimental model of colonic perforation.
abstract: BACKGROUND
  The suture dehiscence has traditionally represented a major surgical problem that has not fully resolved. Surgeons should perform sutures in nonoptimal conditions using different methods of sealing and/or reinforcement of suture. The aim is to assess the effectiveness of TachoSil in an experimental model of colon perforations in a simulated precarious situation.
  
  
  METHODS
  Forty Wistar rats of both genders (14-24 weeks old) were equally divided in 2 groups; study group was submitted to extended starvation and segmental ischemia. The surgical complications analyzed were animal death, colonic leaks, or intra-abdominal infection, either as local abscesses or diffuse peritonitis. The burst pressure was measured in millimeters of mercury. The histological analysis was performed according to Ehrlich and Hunt numerical scale modified by Phillips.
  
  
  RESULTS
  Only 1 animal belonging to the study group died as a consequence of the colonic ischemia. The eventual colonic leak or diffuse peritonitis was reported. Three local abscesses were observed in the study group and one in the control group, and numerous microscopic abscesses in histological analysis (12 vs. 11) were detected. The average burst pressure in the study group was 209.47 ± 50.274 versus 203 ± 51.514 mm Hg in the control group. No differences were observed in any of the variables analyzed in the histological activity.
  
  
  CONCLUSIONS
  TachoSil has proven useful as a sealant of colonic perforations in our experimental study. We therefore conclude that its use in situations of insecurity may be adequate, even in optimal conditions in which reinforcement of previous suture is not strictly required.
authors.affiliation: Hospital Infanta Elena, Huelva, Spain ltallona@hotmail.com.
authors.forename: Luis
authors.initials: L
authors.lastname: Tallón-Aguilar
authors.affiliation: Virgen del Rocio University Hospital/IBiS/CSIC/University of Seville, Sevilla, Spain.
authors.forename: Francisco de Asis
authors.initials: Fde A
authors.lastname: Lopez-Bernal
authors.affiliation: Virgen del Rocio University Hospital/IBiS/CSIC/University of Seville, Sevilla, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Muntane-Relat
authors.affiliation: Virgen del Rocio University Hospital/IBiS/CSIC/University of Seville, Sevilla, Spain.
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: García-Martínez
authors.affiliation: Hospital Universitario Virgen del Rocío, Sevilla, Spain.
authors.forename: Esteban
authors.initials: E
authors.lastname: Castillo-Sanchez
authors.affiliation: Virgen del Rocio University Hospital/IBiS/CSIC/University of Seville, Sevilla, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Padillo-Ruiz
mesh_terms: D000818:Animals; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D004195:Disease Models, Animal; D004338:Drug Combinations; D005260:Female; D005340:Fibrinogen / Q000627:therapeutic use*; D007416:Intestinal Perforation / Q000601:surgery*; D059413:Intraabdominal Infections; D008297:Male; D011183:Postoperative Complications; D011312:Pressure; D051381:Rats; D017208:Rats, Wistar; D013917:Thrombin / Q000627:therapeutic use*
chemical_list: D004338:Drug Combinations; C518955:TachoSil; D005340:Fibrinogen; D013917:Thrombin
keywords: colonic leak; colorectal surgery; experimental study