Expression of transforming growth factor-beta 1 in rabbit anastomotic tissues using three kinds of sutures after tracheotomy: Which one has better histocompatibility?

Liang MO; Yong YOU; Dapu HE; Yuanxing WANG

ABSTRACT

BACKGROUND:

Appropriate anastomosis materials can improve success rate of trachea and bronchus reconstruction.Common domestic suture materials include silk suture, dacron and synthesized absorbable suture. However, the suture with best effects in preventing and lightening scar granulation hyperplasia and luminal stenosis remains Uncertain.

OBJECTIVE:

To compare the influence of three kinds of suture materials on histopathological changes of anastomotic stoma and transforming growth factor-β_1 (TGF-β_1) expression in rabbits following tracheotomy.DESIGN, TIME AND

SETTING:

A randomized, controlled animal experiment and histopathological observation were performed at the Animal Experimental Department, Nanhua University from September 2005 to October 2006.MATERIALS Artificial absorbable suture was purchased from Brazil Johnson & Johnson Professional Products; silk suture and dacron were purchased from Hangzhou Fuyang Medical Suture Factory and Hangzhou Huawei Medical Products Co., Ltd.

METHODS:

A total of 36 New Zealand healthy adult rabbits, regardless of gender, weighing 1.6-2.0 kg, were randomly divided into silk, dacron and artificial absorbable suture groups with 12 animals in each group. The end-to-end anastomosis following tracheotomy was performed using silk, dacron and artificial absorbable suture, respectively.MAIN OUTCOME

MEASURES:

The pathological changes and TGF-β_1 level around the sutures 1, 2, 4 weeks post operation were observed.

RESULTS:

A total of 36 rats were included in final analysis. There were no difference in anastomotic healing between three groups 1 and 2 weeks postoperatively, with a great amount of inflammatory cell infiltration, mainly neutrophil, around the sutures.Moreover, bleeding in the focus and foreign body grannuloma were found. At 4 weeks postoperatively, foreign body grannuloma formed accompanied with obvious firboplasia in silk and dacron groups, and the sutures in the artificial absorbable suture group were absorbed. Compared with 1 and 2 weeks postoperatively, the expression of TGF-β_1 was slightly decreased in silk and dacron groups at 4 weeks (P > 0.05), but the absorbable suture group significantly decreased (P < 0.05).

CONCLUSION:

Of three kinds of suture materials, artificial absorbable suture exhibited good histocompatibility, effectively reducing inflammatory reaction and benefiting the prevention and lightening of formation of pathological scar after tracheal surgery.