Safety and Efficacy of Alginate Adhesion Barrier Gel in Compromised Intestinal Anastomosis
| Autor: | Ankit A. Chaturvedi, Thijs Hendriks, Harry van Goor, Simon T.K. Yauw, Roger M. L. M. Lomme |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Microbiology (medical)
Male medicine.medical_specialty Alginates Sodium hyaluronate Adhesion (medicine) Ileum Anastomotic Leak Tissue Adhesions Anastomosis Peritonitis 03 medical and health sciences chemistry.chemical_compound Random Allocation 0302 clinical medicine Glucuronic Acid medicine Animals Carprofen Hyaluronic Acid Rats Wistar business.industry Hexuronic Acids Anastomosis Surgical Adhesion barrier medicine.disease Intestinal anastomosis Surgery Rats Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10] Infectious Diseases medicine.anatomical_structure chemistry 030220 oncology & carcinogenesis Carboxymethylcellulose Sodium 030211 gastroenterology & hepatology business medicine.drug Abdominal surgery |
| Zdroj: | Surgical Infections, 18, 670-675 Surgical Infections, 18, 6, pp. 670-675 |
| ISSN: | 1557-8674 1096-2964 |
| Popis: | Contains fulltext : 177936.pdf (Publisher’s version ) (Closed access) BACKGROUND: For any anti-adhesive barrier developed for abdominal surgery, the use under conditions in which anastomotic healing is compromised needs to be investigated. The current study evaluates the effect of a new ultrapure alginate gel on early healing of high-risk anastomoses in the ileum and compares this with the gold standard used in clinical practice. MATERIALS AND METHODS: In 75 adult male Wistar rats, a 5 mm ileal segment was resected and continuity was restored by construction of an inverted anastomosis. Rats were divided randomly into a control group and groups receiving either alginate gel or a sodium hyaluronate carboxymethylcellulose (HA/CMC) film around the anastomosis (n = 25 each). Carprofen, given in a daily dose of 1.25 mg/kg, was used to compromise anastomotic healing. At day three, animals were killed and scored for signs of anastomotic leakage and the presence of adhesions. RESULTS: The incidence of adhesion formation was 95% in the HA/CMC film group, which was significantly higher than in the controls (64%, p = 0.010) and the alginate gel group (52%, p = 0.004). The adhesion score was nearly 40% lower in the alginate gel group compared with the HA/CMC film group. The incidence of ileal leakage in the HA/CMC film group (92%) was significantly higher than in the controls (68%, p = 0.016). Leakage rate did not differ between the alginate gel and control groups. There was no significant difference between groups in either incision bursting pressure or incision breaking strength. CONCLUSION: Ultrapure alginate gel does not interfere with repair of ileal anastomoses constructed under conditions in which chances of anastomotic dehiscence are high. The alginate gel performs better than the HA/CMC film. |
| Databáze: | OpenAIRE |
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