Impact of remote ischemic preconditioning on wound healing in small bowel anastomoses.

Abstract:

AIM:To investigate the influence of remote ischemic preconditioning (RIPC) on anastomotic integrity. METHODS:Sixty male Wistar rats were randomized to six groups. The control group (n = 10) had an end-to-end ileal anastomosis without RIPC. The preconditioned groups (n = 34) varied in time of ischemia and time of reperfusion. One group received the amino acid L-arginine before constructing the anastomosis (n = 9). On postoperative day 4, the rats were re-laparotomized, and bursting pressure, hydroxyproline concentration, intra-abdominal adhesions, and a histological score concerning the mucosal ischemic injury were collected. The data are given as median (range). RESULTS:On postoperative day 4, median bursting pressure was 124 mmHg (60-146 mmHg) in the control group. The experimental groups did not show a statistically significant difference (P > 0.05). Regarding the hydroxyproline concentration, we did not find any significant variation in the experimental groups. We detected significantly less mucosal injury in the RIPC groups. Furthermore, we assessed more extensive intra-abdominal adhesions in the preconditioned groups than in the control group. CONCLUSION:RIPC directly before performing small bowel anastomosis does not affect anastomotic stability in the early period, as seen in ischemic preconditioning.

journal_name

World J Gastroenterol

authors

Holzner PA,Kulemann B,Kuesters S,Timme S,Hoeppner J,Hopt UT,Marjanovic G

doi

10.3748/wjg.v17.i10.1308

subject

Has Abstract

pub_date

2011-03-14 00:00:00

pages

1308-16

issue

10

eissn

1007-9327

issn

2219-2840

journal_volume

17

pub_type

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