Abstract
ABSTRACTBackground: The use of measures in colonic anastomoses to prevent dehiscences is of great medical interest. Sugarcane molasses, which has adequate tolerability and compatibility in vivo, has not yet been tested for this purpose. Aim: To analyze the biomechanical parameters of colonic suture in rats undergoing colectomy, using sugarcane molasses polysaccharide as tape or gel. Methods: 45 Wistar rats (Rattus norvegicus albinus) were randomized into three groups of 15 animals: irrigation of enteric sutures with 0.9% saline solution; application of sugarcane molasses polysaccharide as tape; and sugarcane molasses polysaccharide as gel. The rats underwent colon ressection, with subsequent reanastomosis using polypropylene suture; they were treated according to their respective groups. Five rats from each group were evaluated at different times after the procedure: 30, 90 and 180 days postoperatively. The following variables were evaluated: maximum rupture force, modulus of elasticity and specific deformation of maximum force. Results: The biomechanical variables among the scheduled times and treatment groups were statistically calculated. The characteristics of maximum rupture force and modulus of elasticity of the specimens remained identical, regardless of treatment with saline, polysaccharide gel or tape, and treatment time. However, it was found that the specific deformation of maximum force of the intestinal wall was higher after 180 days in the group treated with sugarcane polysaccharide gel (p=0.09). Conclusion: Compared to control, it was detected greater elasticity of the intestinal wall in mice treated with sugarcane polysaccharide gel, without changing other biomechanical characteristics, regardless of type or time of treatment.
Highlights
The dehiscence of enteric anastomoses is a postoperative complication with an incidence of up to 5% in elective surgeries and 15% in emergency
In Group A the suture was irrigated with 5 ml of normal saline solution; in Group B the suture was treated with a SGP tape encircling the anastomosis of the colon; in Group C the suture was treated with 5 ml of 1% SGP gel
Biomechanical variables In order to evaluate the biomechanical characteristics of the test piece, i.e., colon segment with anastomosis after treatments, maximum rupture force, the specific deformation of the maximum force and modulus of elasticity were measured
Summary
The dehiscence of enteric anastomoses is a postoperative complication with an incidence of up to 5% in elective surgeries and 15% in emergency. Their occurrence may result in electrolyte imbalance, malnutrition, infection, sepsis and death[6]. In 1853, Paget introduced the measure of the tensile strength of tissues after severing and surgically repairing the tendons of rabbits; by use of rudimentary technology, he observed that the repaired segment gained strength during the postoperative period. When applied to the intestinal wall, the correlation between this method and that of burst pressure, already established in the literature, showed that the rupture measurements would be the most adequate in the research of the integrity and biological evaluation of anastomoses[15]. Studies cite the use ABCD Arq Bras Cir Dig 2016;29(2):[90-92]
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