Effect of topically applied charged particles on healing of colonic anastomoses.

Guler Mehmet, Kologlu Murat, Kama Nuri Aydin, Renda Nurten, Gozalan Ugur, Yuksek Yunus Nadi, Daglar Gul

Fourth Department of Surgery, Ankara Numune Hospital, Uzmanlar Tip Grubu, 3 Cadde, 41 Sokak, No. 3/1, Bahçelievler, 06500 Ankara, Turkey.

Arch Surg. 2002 Jul;137(7):813-7. doi: 10.1001/archsurg.137.7.813.

HYPOTHESIS

Various forms of electrical stimulation can improve wound healing in different tissues, but their application to gastrointestinal tract healing has not been investigated. We assumed that positively charged diethylaminoethyl cross-linked dextran bead (diethylaminoethyl Sephadex [DEAE-S]) particles would have a beneficial effect on the healing of colonic anastomoses.

DESIGN

Experimental animal study.

SETTING

Animal research laboratory of a university hospital.

ANIMALS

Forty female Wistar albino rats.

INTERVENTIONS

Right colonic transection and anastomosis was performed in 5 animal groups. The control group received no treatment; the placebo group, methylcellulose gel; and the DEAE-S group, DEAE-S in methyl cellulose gel applied topically around the anastomoses. The fecal peritonitis (FP) group underwent cecal ligation and perforation simultaneously with the anastomosis to cause FP; the FP + DEAE-S group also received DEAE-S applied around the anastomoses.

MAIN OUTCOME MEASURES

After the completion of postoperative day 4, all rats were killed. Anastomotic bursting pressures and hydroxyproline concentrations in perianastomotic tissue were measured and compared.

RESULTS

Mean bursting pressures were 115.1 mm Hg in the control group, 113.6 mm Hg in the placebo group, 159.4 mm Hg in the DEAE-S group, 62.8 mm Hg in the FP group, and 121.1 mm Hg in the FP + DEAE-S group (P =.001, 1-way analysis of variance [ANOVA]). The differences between the control vs DEAE-S groups, placebo vs DEAE-S groups, and FP vs FP + DEAE-S groups were significant (P<.05, t test). Mean hydroxyproline concentrations were 5.2 microg/mg in the control group, 4.9 microg/mg in the placebo group, 5.6 microg/mg in the DEAE-S group, 4.5 microg/mg in the FP group, and 5.4 microg/mg in the FP + DEAE-S group (P =.09, 1-way ANOVA). The difference between the FP and FP + DEAE-S groups was significant (P =.04, t test).

CONCLUSIONS

A positively charged particle, DEAE-S, improves healing of colonic anastomoses in healthy rats and in rats with FP. This inexpensive, nontoxic material is easily applied and deserves further evaluation in gastrointestinal tract healing.