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Clinics ; 69(4): 259-264, 4/2014. tab, graf
Artículo en Inglés | LILACS | ID: lil-705782

RESUMEN

OBJECTIVE: Fibrin glues have not been consistently successful in preventing the dehiscence of high-risk colonic anastomoses. Fibrinogen and thrombin concentrations in glues determine their ability to function as sealants, healers, and/or adhesives. The objective of the current study was to compare the effects of different concentrations of fibrinogen and thrombin on bursting pressure, leaks, dehiscence, and morphology of high-risk ischemic colonic anastomoses using fibrin glue in rats. METHODS: Colonic anastomoses in adult female Sprague-Dawley rats (weight, 250-350 g) treated with fibrin glue containing different concentrations of fibrinogen and thrombin were evaluated at post-operative day 5. The interventions were low-risk (normal) or high-risk (ischemic) end-to-end colonic anastomoses using polypropylene sutures and topical application of fibrinogen at high (120 mg/mL) or low (40 mg/mL) concentrations and thrombin at high (1000 IU/mL) or low (500 IU/mL) concentrations. RESULTS: Ischemia alone, anastomosis alone, or both together reduced the bursting pressure. Glues containing a low fibrinogen concentration improved this parameter in all cases. High thrombin in combination with low fibrinogen also improved adherence exclusively in low-risk anastomoses. No differences were detected with respect to macroscopic parameters, histopathology, or hydroxyproline content at 5 days post-anastomosis. CONCLUSIONS: Fibrin glue with a low fibrinogen content normalizes the bursting pressure of high-risk ischemic left-colon anastomoses in rats at day 5 after surgery. .


Asunto(s)
Animales , Femenino , Colon/cirugía , Adhesivo de Tejido de Fibrina/uso terapéutico , Fibrinógeno/administración & dosificación , Isquemia/prevención & control , Trombina/administración & dosificación , Adhesivos Tisulares/uso terapéutico , Anastomosis Quirúrgica , Colágeno/análisis , Colon/irrigación sanguínea , Colon/patología , Hidroxiprolina/análisis , Isquemia/etiología , Presión , Ratas Sprague-Dawley , Reproducibilidad de los Resultados , Factores de Riesgo , Resultado del Tratamiento , Cicatrización de Heridas
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