The comparison of fibroblast count and collagen density score in ileal anastomosis with continuous and interrupted suture technique on New Zealand Rabbit

Abstract

Introduction: Intestinal anastomosis is carried out with the continuous and simple interrupted sutures technique. Simple interrupted suture is the standard technique in intestinal anastomosis nowadays1,2. Continuous suture has better serosal apposition, shorter processing time and triggers the formation of hypoxia-inducible factor (HIF) which can stimulate the production of vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) that stimulate migration and proliferation of mesenchymal cells, especially fibroblast cells which support the synthesis and increasing collagen density in anastomosis tissue. The aim of current study is to compare the anastomosis technique with continuous and simple interrupted sutures reviewed from fibroblast count and collagen density score in rabbit intestines.Method: This study is an experimental study. The sample of this study consisted of 36 rabbits divided into two groups continuous and simple interrupted sutures. Randomization is done by permuted randomization block. The inclusion criteria in this study were rabbit strain Oryctolagus cuniculus aged 8-9 months, weighted 2000-2500 grams, healthy and active. The independent variable in this study is the ileal anastomosis technique and the dependent variable is the fibroblasts count and the collagen density score formed on the anastomosis tissue assessed histopathologically.Results: This study found the average age of the rabbit was 8 months, with an average weight of 2400 grams, the number of fibroblasts in the group of rabbits which received continuous suture was 47 ± 12.679 fibroblasts per visual field with collagen score was 1.88 ± 0.781, whereas in rabbits with interrupted sutures, the fibroblasts count was 42.76 ± 12.47 fibroblasts per visual field with collagen score was 1.82 ± 0.728. However, from the analytic testing showed that the rabbits treated with continuous suture were not significantly different in fibroblast count and collagen density score compared to simple interrupted group (p>0.05), but in continuous rabbit group have higher collagen density scores and fibroblasts count than rabbits who get simple interrupted sutureConclusion: This study proves that continuous suture results in higher fibroblast count and collagen density score than interrupted suture yet statistically insignificant.