title: Fibrinogen-thrombin collagen patch reinforcement of high-risk colonic anastomoses in rats.
abstract: OBJECTIVE
  To evaluate the effectiveness of human fibrinogen-thrombin collagen patch (TachoSil®) in the reinforcement of high-risk colon anastomoses.
  
  
  METHODS
  A quasi-experimental study was conducted in Wistar rats (n= 56) that all underwent high-risk anastomoses (anastomosis with only two sutures) after colectomies. The rats were divided into two randomized groups: Control group (24 rats) and treatment group (24 rats). In the treatment group, high-risk anastomosis was reinforced with TachoSil®(a piece of TachoSil®was applied over this high-risk anastomosis, covering the gap). Leak incidence, overall survival, intra-abdominal adhesions, and histologic healing of anastomoses were analyzed. Survivors were divided into two subgroups and euthanized at 15 and 30 d after intervention in order to analyze the adhesions and histologic changes.
  
  
  RESULTS
  Overall survival was 71.4% and 57.14% in the TachoSil®group and control group, respectively (P= 0.29); four rats died from other causes and six rats in the treatment group and 10 in the control group experienced colonic leakage (P> 0.05). The intra-abdominal adhesion score was similar in both groups, with no differences between subgroups. We found non-significant differences in the healing process according to the histologic score used in both groups (P= 0.066).
  
  
  CONCLUSIONS
  In our study, the use of TachoSil®was associated with a non-statistically significant reduction in the rate of leakage in high-risk anastomoses. TachoSil®has been shown to be a safe product because it does not affect the histologic healing process or increase intra-abdominal adhesions.
authors.affiliation: Juan Manuel Suárez-Grau, Department of General and Digestive Surgery, Riotinto Hospital, 21660 Huelva, Spain.
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Suárez-Grau
authors.affiliation: Juan Manuel Suárez-Grau, Department of General and Digestive Surgery, Riotinto Hospital, 21660 Huelva, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Bernardos García
authors.affiliation: Juan Manuel Suárez-Grau, Department of General and Digestive Surgery, Riotinto Hospital, 21660 Huelva, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Cepeda Franco
authors.affiliation: Juan Manuel Suárez-Grau, Department of General and Digestive Surgery, Riotinto Hospital, 21660 Huelva, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Mendez García
authors.affiliation: Juan Manuel Suárez-Grau, Department of General and Digestive Surgery, Riotinto Hospital, 21660 Huelva, Spain.
authors.forename: Salud
authors.initials: S
authors.lastname: García Ruiz
authors.affiliation: Juan Manuel Suárez-Grau, Department of General and Digestive Surgery, Riotinto Hospital, 21660 Huelva, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Docobo Durantez
authors.affiliation: Juan Manuel Suárez-Grau, Department of General and Digestive Surgery, Riotinto Hospital, 21660 Huelva, Spain.
authors.forename: Salvador
authors.initials: S
authors.lastname: Morales-Conde
authors.affiliation: Juan Manuel Suárez-Grau, Department of General and Digestive Surgery, Riotinto Hospital, 21660 Huelva, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Padillo Ruiz
keywords: Anastomosis; Colon; Leak; Rats; Surgery; TachoSil®