Influence of pulsed electromagnetic fields on healing of experimental colonic anastomosis

Abstract

The study investigated the influence of pulsed electromagnetic fields (PEMFs) on the mechanical strength and collagen content of uncomplicated colonic anastomosis in rats. A standardized left colonic resection was performed 3 cm above the peritoneal reflection, and end-to-end anastomosis was constructed with eight interrupted inverting sutures. Beginning immediately after surgery, randomly assigned groups were exposed to one of the following: 1) 100 Hz (frequency), 1 mT (intensity) PEMFs with 16-hour on/8-hour off cycles (n = 8); 2) 100 Hz, 2 mT PEMFs with 16-hour on/8-hour off cycles (n = 8); 3) 100 Hz, 1 mT PEMFs with 6-hour on/6-hour off cycles (n = 6), whereas the control group (n = 10) received no PEMFs. Relaparatomy was performed at 72 hours postoperatively, and the bursting pressure of the anastomotic segment was recorded in situ. The hydroxyproline contents of the anastomotic and adjacent perianastomotic segments of equal lengths were determined. Mean bursting pressure values of the groups that received 100 Hz, 1 or 2 mT PEMFs with 16-hour on/8-hour off cycles (90.88 +/- 19.13 and 83.88 +/- 7.08 mmHg, respectively) were significantly higher than those of the control group (61.66 +/- 10.6 mmHg) and the group with 6-hour on/6-hour off cycles (64.83 +/- 7.36 mmHg; P < 0.05 for all comparisons). Hydroxyproline contents of the anastomotic and perianastomotic segments were consistently higher in the 16-hour on/8-hour off PEMF groups, compared with those of the corresponding segments of the control group. PEMFs applied externally to unrestrained rats within a "window of PEMF parameters" provided a significant gain in the mechanical strength of the colonic anastomosis, at least 72 hours post-operatively. Associated relative increases in the hydroxyproline contents of the (peri)anastomotic colonic segments suggest that an altered collagen metabolism might contribute to this enhancement of the anastomotic repair. Further investigations based on these preliminary data and the definition of the exact measures regarding the effects of PEMFs on biologic systems, in general, may lead to an efficient and new adjunctive modality in colorectal surgery.