成纤维细胞生长因子局部缓释对食管吻合口伤口愈合的影响。

The effects of local and sustained release of fibroblast growth factor on wound healing in esophageal anastomoses.

作者信息

Fedakar-Senyucel Mine, Bingol-Kologlu Meltem, Vargun Rahsan, Akbay Canan, Sarac F Nurşen, Renda Nurten, Hasirci Nesrin, Gollu Gulnur, Dindar Huseyin

机构信息

Department of Pediatric Surgery, School of Medicine, Ankara University, 06100 Ankara, Turkey.

出版信息

J Pediatr Surg. 2008 Feb;43(2):290-5. doi: 10.1016/j.jpedsurg.2007.10.016.

DOI:10.1016/j.jpedsurg.2007.10.016

PMID:18280276

Abstract

BACKGROUND/PURPOSE: Postsurgical complications, such as anastomotic leaks in patients with esophageal atresia, have remained unchanged during the last 3 decades. Growth factors enhance healing in several wound-healing models. Therefore, an experimental study was used to evaluate the effects of local and sustained release of basic fibroblast growth factor (FGF) on wound healing in esophageal anastomoses.

MATERIALS AND METHODS

Twenty-four male Wistar albino rats, which were subjected to a 1-cm segmental resection of the abdominal esophagus followed by end-to-end anastomosis, were allocated into 3 groups. Group I, the control group, had no gelatin film applied to the anastomosis. In group II (gelatin film without FGF) and group III (gelatin film with FGF), anastomoses were covered with unloaded and 2.55 mug FGF-loaded gelatin films, respectively. On postoperative day 7, bursting pressures, histopathologic collagen deposition, and tissue hydroxyproline concentrations of the anastomoses were then analyzed and compared.

RESULTS

Mean bursting pressures, mean submucosal and muscular collagen deposition scores, and mean tissue hydroxyproline concentrations differed significantly between groups. Mean bursting pressures were 22.5 +/- 3.1 mm Hg in group I, 29 +/- 1.6 mm Hg in group II, and 63.2 +/- 6.8 mm Hg in group III (P < .001). Mean submucosal collagen deposition scores (group I: 0.7 +/- 0.2, group II: 0.7 +/- 0.1, group III: 1.5 +/- 0.2; P = .02) and mean muscular collagen deposition scores (group I: 0.8 +/- 0.2, group II: 0.8 +/- 0.1, group III: 1.8 +/- 0.1; P = .01) were significantly higher in FGF animals than the other in the other 2 groups. Mean tissue hydroxyproline concentrations were 2.4 +/- 0.5 microg/mg in group I, 3.9 +/- 0.4 microg/mg in group II, and 6.0 +/- 1.0 microg/mg in group III (P = .007).

CONCLUSION

Local and sustained release of FGF enhanced wound healing in esophageal anastomoses in this animal model.

摘要

背景/目的：在过去30年里，诸如食管闭锁患者吻合口漏等术后并发症一直没有改变。生长因子在多种伤口愈合模型中可促进愈合。因此，本实验研究旨在评估碱性成纤维细胞生长因子（FGF）局部持续释放对食管吻合口伤口愈合的影响。

材料与方法

将24只雄性Wistar白化大鼠进行腹部食管1厘米节段切除并端端吻合，分为3组。I组为对照组，吻合口未应用明胶膜。II组（不含FGF的明胶膜组）和III组（含FGF的明胶膜组），吻合口分别覆盖未载药和载有2.55微克FGF的明胶膜。术后第7天，分析并比较吻合口的破裂压力、组织病理学胶原沉积及组织羟脯氨酸浓度。

结果

各组间平均破裂压力、平均黏膜下层和肌层胶原沉积评分以及平均组织羟脯氨酸浓度存在显著差异。I组平均破裂压力为22.5±3.1毫米汞柱，II组为29±1.6毫米汞柱，III组为63.2±6.8毫米汞柱（P<.001）。FGF组的平均黏膜下层胶原沉积评分（I组：0.7±0.2，II组：0.7±0.1，III组：1.5±0.2；P=.02）和平均肌层胶原沉积评分（I组：0.8±0.2，II组：0.8±0.1，III组：1.8±0.1；P=.01）显著高于其他两组。I组平均组织羟脯氨酸浓度为2.4±0.5微克/毫克，II组为3.9±0.4微克/毫克，III组为6.0±1.0微克/毫克（P=.00７）。