thesis
The influence of fibrin sealant on the healing colonic anastomosis : an experimental study in rats
- Publication date
- 29 September 1993
- Publisher
- The experiments described in this thesis were performed in order to find methods to
influence and improve colonic anastomotic wound healing. It is known that inflammation may
affect the healing of colonic anastomoses. Eicosanoids are known mediators of the
inflammatory process, being a part of the healing process. In order to influence the healing
process anti inflammatory drugs may be used. To evaluate the possible role of eicosanoids
in uncomplicated healing of colon anastomosis we decided to measure eicosanoid synthesis
in colon tissue and peritoneal macrophages. Activity of peritoneal macrophages was studied
based on the HPLC profile of eicosanoids. Colon tissue was studied as well in order to
compare both profiles to establish which cell type is active in the healing colon (Chapter IV).
Colonic anastomoses may be covered with fibrin sealant in order to promote wound healing
and prevent leakage. Presently, this is already performed in many clinical situations. However
data from experimental animal studies are conflicting, and prospective clinical studies are
lacking. The influence of human· and rat fibrin sealant on the mechanical strength en collagen
metabolism of a sutured colonic anastomoses is investigated (Chapter V).
Ischemia of the wound margins is a high-risk condition in the healing colonic anastomosis,
with a considerable chance of anastomotic dehiscence. The effect of fibrin sealant on the
healing ischemic anastomosis is tested (Chapter VI). Another known risk-factor is the
presence of peritonitis. The role of fibrin sealant in the presence of faecal peritonitis is
described in Chapter VII. A technical imperfect anastomosis may result in leakage of
intestinal contents. In order to examen the effect of fibr