van der Ham A C, Kort W J, Weijma I M, van den Ingh H F, Jeekel J
Laboratory for Experimental Surgery, Erasmus University, Rotterdam, The Netherlands.
Br J Surg. 1991 Jan;78(1):49-53. doi: 10.1002/bjs.1800780117.
Fibrin adhesives have been advocated as a protective seal in colonic anastomosis to prevent leakage. In order to assess the effect of fibrin glue sealing we compared the healing of sutured colonic anastomosis in the rat (group 1) with the addition of human-derived fibrin sealant (group 2). As a control for a possible reaction to foreign protein, in group 3 the sutured anastomosis was sealed with specially prepared rat fibrin adhesive. On days 2, 4 and 7, ten animals in each group were killed. Adhesion formation was scored and the in situ bursting pressure was measured. The collagen concentration and degradation were estimated by measuring hydroxyproline. Adhesion formation was significantly increased in groups 2 and 3 compared with the control group. On days 2 and 7 the bursting pressure was not different between the groups. On day 4 the bursting pressure in groups 2 and 3 was significantly lower than in group 1 (P less than 0.001). These findings correspond with the results of collagen measurements. On day 4 the concentration of hydroxyproline was significantly reduced in groups 2 and 3. Histological examination showed infiltration of neutrophilic granulocytes into the sealant on days 2 and 4; on day 7 the sealant had vanished. From these results it is concluded that fibrin sealing of the colonic anastomosis in the rat does not improve healing, as demonstrated by bursting pressure and hydroxyproline concentration. On the contrary, it seems to have a negative influence.
纤维蛋白粘合剂被提倡作为结肠吻合术中的一种保护性密封剂以防止渗漏。为了评估纤维蛋白胶密封的效果，我们将大鼠缝合结肠吻合术的愈合情况（第1组）与添加人源纤维蛋白密封剂后的情况（第2组）进行了比较。作为对可能的外来蛋白反应的对照，在第3组中，用特制的大鼠纤维蛋白粘合剂密封缝合的吻合口。在第2、4和7天，每组处死10只动物。对粘连形成进行评分并测量原位破裂压力。通过测量羟脯氨酸来估计胶原蛋白的浓度和降解情况。与对照组相比，第2组和第3组的粘连形成明显增加。在第2天和第7天，各组之间的破裂压力没有差异。在第4天，第2组和第3组的破裂压力明显低于第1组（P小于0.001）。这些发现与胶原蛋白测量结果一致。在第4天，第2组和第3组的羟脯氨酸浓度明显降低。组织学检查显示，在第2天和第4天有中性粒细胞浸润到密封剂中；在第7天，密封剂消失。从这些结果可以得出结论，大鼠结肠吻合术的纤维蛋白密封并没有改善愈合情况，这通过破裂压力和羟脯氨酸浓度得到证明。相反，它似乎有负面影响。
