Effects of polyurethane membrane on septic colon anastomosis and intra-abdominal adhesions

BACKGROUND: Anastomotic leakages and adhesions after gastrointestinal tract surgery are still a significant cause of morbidity and mortality. The rate of anastomotic leakage is 3%-8%, whereas the mortality from leakage is over 30%. Intra-abdominal sepsis is a well-known cause of anastomotic leakage. In addition, intra-abdominal adhesion is a major cause of hospital admissions and reoperations and is associated with morbidity and mortality. In this study, we aimed to investigate the effects of a polyurethane membrane on anastomotic healing and intra-abdominal adhesions.

METHODS: This study used 32 Wistar albino rats divided into four groups. Standard resection of left colon 2 cm above the peritoneal reflection and colonic anastomosis were performed after causing abdominal sepsis through caecal ligation and perforation. The control groups (1 and 3) received no further treatment. The experimental groups (2 and 4) received the polyurethane membrane around the colonic anastomosis. Burst pressure, hydroxyproline, interleukin-6 (IL-6), nitric oxide (NO), tissue plasminogen activator (tPA), and tumor necrosis factor-alpha (TNF-α) levels were measured, and histopathological characteristics of the anastomosis were analyzed after re-laparotomy. Moreover, adhesion scores were measured.

RESULTS: No statistically significant differences were found in the mean burst pressure levels between sacrificed animals on days three and five (p=0.259, p=0.177). When all the groups were compared, no significant difference was observed in the hydroxyproline, NO, and IL-6 levels (p=0.916, p=0.429, p=0.793, p=0.332, p=0.400, p=0.317). However, in groups 2 and 4, the tPA levels were significantly increased by Opsite therapy (p=0.001, p=0.003), and a statistically significant difference was observed in the adhesion scores (p<0.035). Groups 2 and 4 had significantly lower adhesion scores than groups 1 and 3.

CONCLUSION: We found that Opsite therapy had no positive or negative effects on histopathological and biochemical healing in the experimental septic colon anastomosis model. However, the perianastomotic application of polyurethane membrane effectively decreased the intra-abdominal adhesions.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:27

Enthalten in:

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES - 27(2021), 1 vom: 04. Jan., Seite 1-8

Sprache:

Englisch

Weiterer Titel:

Poliüretan membranın karıniçi adezyonlar ve septik kolon anastomuzu üzerine etkileri

Beteiligte Personen:

Yılmaz, Gökhan [VerfasserIn]
Özdenkaya, Yaşar [VerfasserIn]
Karatepe, Oğuzhan [VerfasserIn]
Tanrıkulu, Yusuf [VerfasserIn]
Kamalı, Gülçin [VerfasserIn]
Yalçın, Orhan [VerfasserIn]

Links:

Volltext

Themen:

Journal Article
Membranes, Artificial
Polyurethanes

Anmerkungen:

Date Completed 13.05.2021

Date Revised 13.05.2021

published: Print

Citation Status MEDLINE

doi:

10.14744/tjtes.2020.41624

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM319584461