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International Journal of Colorectal Disease
Erschienen in: International Journal of Colorectal Disease 5/2009

01.05.2009 | Original Article

Effects of amniotic membrane on the healing of primary colonic anastomoses in the cecal ligation and puncture model of secondary peritonitis in rats

verfasst von: Mehmet Uludag, Bulent Citgez, Ozay Ozkaya, Gurkan Yetkin, Omer Ozcan, Nedim Polat, Adnan Isgor

Erschienen in: International Journal of Colorectal Disease | Ausgabe 5/2009

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Abstract

Purpose

We aimed to investigate the effects of amniotic membrane on primary colonic anastomoses in a rat peritonitis model.

Materials and methods

Fifty female Sprague Dawley rats were used in the study. Bacterial peritonitis was induced in all rats by performing a cecal ligation and puncture. Ten rats served as controls for the bursting pressure measurement, while the other 40 animals were divided into two groups (the anastomosis group (P) or the amniotic membrane group (PA)), and all of them underwent colonic anastomosis. The latter group had amniotic membrane covering their anastomoses. Half of the PA and P groups were sacrificed on the third postoperative day (PA3, P3), and the other half on the seventh postoperative day (PA7, P7).

Results

The bursting pressures were significantly higher in groups PA3 and PA7 compared with P3 (p < 0.01) and P7 (p < 0.05), respectively. Inflammatory cell infiltration and adhesion scores were significantly lower in groups PA3 and PA7 compared with groups P3 (p < 0.001, p < 0.01, respectively) and P7 (p < 0.001, p < 0.05, respectively). Neoangiogenesis, fibroblast activity, collagen deposition, and hydroxyproline concentrations were significantly higher in groups with amniotic membrane than in groups without amniotic membrane (p < 0.05, for all comparisons).

Conclusion

This study showed that the covering of colonic anastomoses with amniotic membrane significantly prevented the delaying effect of intraperitoneal sepsis and provided a safer and stronger anastomosis than suture and that this was the case for both the early and late phases of anastomotic healing in the colon.
Literatur
1.
Wittmann DH, Schein M, Condon RE (1996) Management of secondary peritonitis. Ann Surg 224:10–18PubMedCrossRef
2.
Ordoñez CA, Puyana JC (2006) Management of peritonitis in the critically ill patient. Surg Clin North Am 86:1323–1349PubMedCrossRef
3.
Pieracci FM, Barie PS (2007) Management of severe sepsis of abdominal origin. Scand J Surg 96:184–196PubMed
4.
Murray JJ (1991) Nonelective colon resection. Alternatives to multistage resections. Surg Clin North Am 71:1187–1194PubMed
5.
Wedell J, Banzhaf G, Chaoui R et al (1997) Surgical management of complicated colonic diverticulitis. Br J Surg 84:380–383PubMedCrossRef
6.
Richter S, Lindemann W, Kollmar O et al (2006) One-stage sigmoid colon resection for perforated sigmoid diverticulitis (Hinchey stages III and IV). World J Surg 30:1027–1032PubMedCrossRef
7.
Regenet N, Pessaux P, Hennekinne S et al (2003) Primary anastomosis after intraoperative colonic lavage vs. Hartmann’s procedure in generalized peritonitis complicating diverticular disease of the colon. Int J Colorectal Dis 18:503–507PubMedCrossRef
8.
Kayaalp C, Balkan M, Aydin C et al (2003) Comparison of primary colonic anastomosis and colostomy in experimental localized fecal peritonitis. Ulus Travma Acil Cerrahi Derg 9:160–162 (Turkish)PubMed
9.
Thornton FJ, Barbul A (1997) Healing in the gastrointestinal tract. Surg Clin North Am 77:549–573PubMedCrossRef
10.
Ahrendt GM, Tantry US, Barbul A (1996) Intra-abdominal sepsis impairs colonic reparative collagen synthesis. Am J Surg 171:102–107PubMedCrossRef
11.
Irvin TT (1976) Collagen metabolism in infected colonic anastomoses. Surg Gynecol Obstet 143:220–224PubMed
12.
Aytekin FO, Teke Z, Aydin C et al (2007) Effects of a membrane-permeable radical scavenger, Tempol, on healing of colonic anastomoses in the cecal ligation and puncture model of polymicrobial sepsis in rats. Am J Surg 193:723–729PubMedCrossRef
13.
Teke Z, Aytekin FO, Aydin C et al (2007) Effects of pyrrolidone dithiocarbamate on healing of colonic anastomoses in the cecal ligation and puncture model of intraperitoneal sepsis in rats. World J Surg 31:200–209PubMedCrossRef
14.
Li Y, Bao Y, Jiang T et al (2006) Effect of the combination of fibrin glue and growth hormone on incomplete intestinal anastomoses in a rat model of intra-abdominal sepsis. J Surg Res 131:111–117PubMedCrossRef
15.
Dilek ON, Bakir B, Dilek FH et al (1996) Protection of intestinal anastomoses in septic environment with peritoneal graft and polyglycolic acid mesh: an experimental study. Acta Chir Belg 96:261–265PubMed
16.
Naycı A, Cömelekoğlu U, Cıngı E et al (2005) Does sepsis impair the healing of colonic anastomosis in splenectomized rats? Ulus Travma Derg 11:282–286 (Turkish)PubMed
17.
Niknejad H, Peirovi H, Jorjani M et al (2008) Properties of the amniotic membrane for potential use in tissue engineering. Eur Cell Mater 15:88–99PubMed
18.
Toda A, Okabe M, Yoshida T et al (2007) The potential of amniotic membrane/amnion-derived cells for regeneration of various tissues. J Pharmacol Sci 105:215–228PubMedCrossRef
19.
Park WC, Tseng SC (2000) Modulation of acute inflammation and keratocyte death by suturing, blood, and amniotic membrane in PRK. Invest Ophthalmol Vis Sci 41:2906–2914PubMed
20.
Kim TH, Lee DY, Rho JH et al (2006) Application of newly developed amniotic membrane ointment for photorefractive keratectomy in rabbits. Ophthalmic Res 38:58–61PubMedCrossRef
21.
He H, Li W, Chen SY et al (2008) Amniotic membrane extract suppresses activation and induces apoptosis in RAW264.7 cells. Invest Ophthalmol Vis Sci 49:4468–4475 Jul 9 [Epub ahead of print]PubMedCrossRef
22.
Menon R, Ismail L, Ismail D et al (2006) Human fetal membrane expression of IL-19 and IL-20 and its differential effect on inflammatory cytokine production. J Matern Fetal Neonatal Med 19:209–214PubMedCrossRef
23.
Koizumi NJ, Inatomi TJ, Sotozono CJ et al (2000) Growth factor mRNA and protein in preserved human amniotic membrane. Curr Eye Res 20:173–177PubMedCrossRef
24.
Cromack DT, Sporn MB, Roberts AB et al (1987) Transforming growth factor beta levels in rat wound chambers. J Surg Res 42:622–628PubMedCrossRef
25.
Wichterman KA, Baue AE, Chaudry IH (1980) Sepsis and septic shock—a review of laboratory models and a proposal. J Surg Res 29:189–201PubMedCrossRef
26.
van der Ham AC, Kort WJ, Weijma IM et al (1992) Effect of antibiotics in fibrin sealant on healing colonic anastomoses in the rat. Br J Surg 79:525–528PubMedCrossRef
27.
Phillips JD, Kim CS, Fonkalsrud EW et al (1992) Effects of chronic corticosteroids and vitamin A on the healing of intestinal anastomoses. Am J Surg 163:71–77PubMedCrossRef
28.
Bergman I, Loxley R (1963) Two improved and simplified methods fort he spectrophotometric determination of hydroxyproline. Anal Chem 35:1961–1965CrossRef
29.
Christensen H, Oxlund H (1994) Growth hormone increases the collagen deposition rate and breaking strength of left colonic anastomoses in rats. Surgery 116:550–556PubMed
30.
Ishimura K, Tsubouchi T, Okano K et al (1998) Wound healing of intestinal anastomosis after digestive surgery under septic conditions: participation of local interleukin-6 expression. World J Surg 22:1069–1075PubMedCrossRef
31.
32.
Otero-Antón E, González-Quintela A, López-Soto A et al (2001) Cecal ligation and puncture as a model of sepsis in the rat: influence of the puncture size on mortality, bacteremia, endotoxemia and tumor necrosis factor alpha levels. Eur Surg Res 33:77–79PubMedCrossRef
33.
Salgado Júnior W, Santos JS, Cunha Fde Q (2007) Development of a lethal model of peritonitis for assessment of laparoscopic and laparotomic treatments in rats. Acta Cir Bras 22:39–42PubMedCrossRef
34.
Bedirli A, Gokahmetoglu S, Sakrak O et al (2003) Prevention of intraperitoneal adhesion formation using beta-glucan after ileocolic anastomosis in a rat bacterial peritonitis model. Am J Surg 185:339–343PubMedCrossRef
35.
Teke Z, Sacar S, Yenisey C et al (2008) Role of activated protein C on wound healing process in left colonic anastomoses in the presence of intra-abdominal sepsis induced by cecal ligation and puncture: an experimental study in the rat. World J Surg 32:2434–2443PubMedCrossRef
36.
diZerega GS (1997) Biochemical events in peritoneal tissue repair. Eur J Surg (Suppl 577):10–16
37.
van Goor H, de Graaf JS, Grond J et al (1994) Fibrinolytic activity in the abdominal cavity of rats with faecal peritonitis. Br J Surg 81:1046–1049PubMedCrossRef
38.
Trelford-Sauder M, Dawe EJ, Trelford JD (1978) Use of allograft amniotic membrane for control of intra-abdominal adhesions. J Med 9:273–284PubMed
39.
Kelekci S, Uygur D, Yilmaz B et al (2007) Comparison of human amniotic membrane and hyaluronate/carboxymethylcellulose membrane for prevention of adhesion formation in rats. Arch Gynecol Obstet 276:355–359PubMedCrossRef
40.
Raftery AT (1973) Regeneration of parietal and visceral peritoneum: an electron microscopical study. J Anat 115:375–392PubMed
41.
diZerega GS, Campeau JD (2001) Peritoneal repair and post-surgical adhesion formation. Hum Reprod Update 7:547–555PubMedCrossRef
42.
Zeng Q, Yu Z, You J et al (2007) Efficacy and safety of Seprafilm for preventing postoperative abdominal adhesion: systematic review and meta-analysis. World J Surg 31:2125–2131PubMedCrossRef
43.
Essani NA, Fisher MA, Farhood A et al (1995) Cytokine-induced upregulation of hepatic intercellular adhesion molecule-1 messenger RNA expression and its role in the pathophysiology of murine endotoxin shock and acute liver failure. Hepatology 21:1632–1639PubMed
44.
Patel RT, Deen KI, Youngs D et al (1994) Interleukin 6 is a prognostic indicator of outcome in severe intra-abdominal sepsis. Br J Surg 81:1306–1368PubMedCrossRef
45.
Holzheimer RG, Schein M, Wittmann DH (1995) Inflammatory response in peritoneal exudate and plasma of patients undergoing planned relaparotomy for severe secondary peritonitis. Arch Surg 130:1314–1319PubMed
46.
Rico RM, Ripamonti R, Burns AL et al (2002) The effect of sepsis on wound healing. J Surg Res 102:193–197PubMedCrossRef
47.
Heiligenhaus A, Li H, Yang Y et al (2004) Amniotic membrane transplantation improves experimental herpetic keratitis. Modulation of matrix metalloproteinase-9. Ophthalmologe 101:59–65PubMedCrossRef
48.
Rinastiti M, Harijadi, Santoso AL et al (2006) Histological evaluation of rabbit gingival wound healing transplanted with human amniotic membrane. Int J Oral Maxillofac Surg 35:247–251PubMedCrossRef
49.
Talmi YP, Sigler L, Inge E et al (1991) Antibacterial properties of human amniotic membranes. Placenta 12(3):285–288PubMedCrossRef
50.
Witte MB, Barbul A (1997) General principles of wound healing. Surg Clin North Am 77:509–528PubMedCrossRef
51.
LeVeen HH, Wapnick S, Falk G et al (1976) Effects of prophylactic antibiotics on colonic healing. Am J Surg 131:47–53PubMedCrossRef
52.
Xing L, Franz MG, Marcelo CL et al (2007) Amnion-derived multipotent progenitor cells increase gain of incisional breaking strength and decrease incidence and severity of acute wound failure. J Burns Wounds 5(7):e5
53.
Kobayashi N, Kabuyama Y, Sasaki S et al (2002) Suppression of corneal neovascularization by culture supernatant of human amniotic cells. Cornea 21:62–67PubMedCrossRef
54.
Shao C, Sima J, Zhang SX et al (2004) Suppression of corneal neovascularization by PEDF release from human amniotic membranes. Invest Ophthalmol Vis Sci 45:1758–1762PubMedCrossRef
55.
Agren MS, Andersen TL, Mirastschijski U et al (2006) Action of matrix metalloproteinases at restricted sites in colon anastomosis repair: an immunohistochemical and biochemical study. Surgery 140:72–82PubMedCrossRef
56.
Cohen KI, Diegelmann RF, Yager DR et al (1999) Wound care and wound healing. In: Schwartz SI, Shires GT, Spencer FC, Daly JM, Fischer JE, Galloway AC (eds) Principles of surgery, 7th edn. McGraw-Hill, New York, pp 263–295
Metadaten
Titel
Effects of amniotic membrane on the healing of primary colonic anastomoses in the cecal ligation and puncture model of secondary peritonitis in rats
verfasst von
Mehmet Uludag
Bulent Citgez
Ozay Ozkaya
Gurkan Yetkin
Omer Ozcan
Nedim Polat
Adnan Isgor
Publikationsdatum
01.05.2009
Verlag
Springer-Verlag
Erschienen in
International Journal of Colorectal Disease / Ausgabe 5/2009
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-009-0645-y

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