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 of colonic anastomoses in rats with and without faecal peritonitis. Design: Controlled study. Setting: Laboratory for experimental surgery, Erasmus University Rotterdam, The Netherlands. Material. 120 male Wag/Rij rats. Interventions: All rats had a single layer end-to-end anastomosis fashioned with 7/0 polypropylene. Faecal peritonitis was then induced in half of the rats by placement of 200 mg powdered autoclaved rat faeces in the peritoneal cavity near the anastomosis. Rats were allocated 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, anastomotic bursting pressure and collagen concentration around the anastomosis on days 2, 4, and 7 in 10 rats from each group. Results: 11 rats died of peritonitis before the experiment was completed. Peritonitis caused increased formation of adhesions and abscesses, with or without fibrin sealant. Bursting pressure at the anastomosis was significantly reduced in peritonitis compared with controls on days 4 and 7, and this was not prevented by fibrin. Sealing of anastomoses resulted in lower bursting pressures on day 4 in control animals. Collagen concentration was significantly reduced in peritonitis with or without fibrin sealant on days 4 and 7, and after fibrin sealing of control anastomoses. Conclusion: Faecal peritonitis reduced mechanical strength and collagen concentration of colonic anastomoses, and this was not prevented by additional sealing of the anastomosis with fibrin sealant.