EFFECT OF FIBRIN SEALANT ON THE INTEGRITY OF COLONIC ANASTOMOSES IN RATS WITH FECAL PERITONITIS

Objective: To assess the influence of fibrin adhesive on the healing o f colonic anastomoses in rats with and without faecal peritonitis. Des ign: Controlled study. Setting: Laboratory for experimental surgery, E rasmus University Rotterdam, The Netherlands. Material. 120 male Wag/R ij rats. Interventions: All rats had a single layer end-to-end anastom osis fashioned with 7/0 polypropylene. Faecal peritonitis was then ind uced in half of the rats by placement of 200 mg powdered autoclaved ra t faeces in the peritoneal cavity near the anastomosis. Rats were allo cated to one of four groups (n = 30 in each): 1-control; 2-additional sealing with fibrin glue; 3-peritonitis alone; and 4-peritonitis with fibrin glue. Main outcome measures: Body weight, adhesion formation, a nastomotic bursting pressure and collagen concentration around the ana stomosis on days 2, 4, and 7 in 10 rats from each group. Results: 11 r ats died of peritonitis before the experiment was completed. Peritonit is caused increased formation of adhesions and abscesses, with or with out fibrin sealant. Bursting pressure at the anastomosis was significa ntly reduced in peritonitis compared with controls on days 4 and 7, an d this was not prevented by fibrin. Sealing of anastomoses resulted in lower bursting pressures on day 4 in control animals. Collagen concen tration was significantly reduced in peritonitis with or without fibri n sealant on days 4 and 7, and after fibrin sealing of control anastom oses. Conclusion: Faecal peritonitis reduced mechanical strength and c ollagen concentration of colonic anastomoses, and this was not prevent ed by additional sealing of the anastomosis with fibrin sealant.