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壳聚糖涂层对手术缝线强化结肠吻合术的作用。

Effect of chitosan coating on surgical sutures to strengthen the colonic anastomosis.

作者信息

Altınel Yüksel, Chung Soon Soup, Okay Güven, Uğraş Nesrin, Işık Ahmet Fatih, Öztürk Ersin, Özgüç Halil

机构信息

Department of General Surgery, Uludağ University Faculty of Medicine, Bursa-Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2018 Sep;24(5):405-411. doi: 10.5505/tjtes.2018.59280.

Abstract

BACKGROUND

We evaluated the feasibility of chitosan-coated sutures for intestinal anastomosis strength through wound-healing effect.

METHODS

Vicryl and PDS sutures were coated with 2% chitosan. While laparotomy was applied to the first group, chitosan was applied in the peritoneal cavity in the second group. Then the following materials were applied to colon anastomosis, in order: Vicryl, PDS, chitosan-coated Vicryl, and chitosan-coated PDS sutures. On the 7th and 14th days, eight rats from each group were euthanized.

RESULTS

The adhesion scores of chitosan and control groups were lower than the suture groups. The vascularization of Vicryl-chitosan was lower than PDS-chitosan on the 14th day (p=0.038). Fibroblast cells and vascularization of anastomosis with chitosan-coated Vicryl were lower than Vicryl and chitosan-coated PDS on the 14th day (p<0.05). The tensile strength of Vicryl-chitosan increased more than Vicryl in vitro (p<0.05) on the 14th and 7th days, but there was no difference in vivo. The tensile strength of PDS-chitosan decreased more than PDS on the 7th day in vivo (p<0.05).

CONCLUSION

The chitosan-coating effect on the adhesion and reinforcement of anastomosis in some parts of Vicryl in vitro and PDS in vivo was slightly improved.

摘要

背景

我们通过伤口愈合效果评估了壳聚糖涂层缝线用于增强肠吻合强度的可行性。

方法

将2%的壳聚糖涂覆于薇乔缝线和聚对二氧环己酮缝线上。第一组实施剖腹术,第二组将壳聚糖应用于腹腔。然后依次将以下材料用于结肠吻合:薇乔缝线、聚对二氧环己酮缝线、壳聚糖涂层薇乔缝线和壳聚糖涂层聚对二氧环己酮缝线。在第7天和第14天,每组处死8只大鼠。

结果

壳聚糖组和对照组的粘连评分低于缝线组。在第14天,薇乔-壳聚糖组的血管化程度低于聚对二氧环己酮-壳聚糖组(p = 0.038)。在第14天,壳聚糖涂层薇乔缝线吻合处的成纤维细胞和血管化程度低于薇乔缝线组和壳聚糖涂层聚对二氧环己酮缝线组(p < 0.05)。在第14天和第7天,薇乔-壳聚糖组的体外抗张强度比薇乔缝线增加得更多(p < 0.05),但在体内无差异。在第7天,聚对二氧环己酮-壳聚糖组的体内抗张强度比聚对二氧环己酮下降得更多(p < 0.05)。

结论

壳聚糖涂层对薇乔缝线部分体外吻合以及聚对二氧环己酮缝线体内吻合的粘连和加固作用有轻微改善。

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