Estudo comparativo entre os fios de algodão, poliglactina e poliglecaprone nas anastomoses intestinais de cães

Abstract

-Background -Over the years, many sutures were developed and then abandoned. Until now was not found an ideal suture to the intestinal tract or other tissues in general, making the choice a difficult task. Aim -To evaluate, macroscopically and microscopically, the healing process of intestinal anastomoses in dogs using polyglecaprone 25, polyglactin 910 and cotton sutures. MethodsTwenty adult male dogs were operated on and underwent to three small bowel anastomosis using the technique with submucosal sutures. Were used three threads and the anastomoses were evaluated at different postoperative periods -group I -three days; group II -seven days; group III -14 days and group IV -21days. Macroscopic analysis was to assess the presence or absence of peritonitis, aspect of the anastomosis and adhesions. Histological studies of the anastomoses, using hematoxylin and eosin and Masson's trichrome analyzed the exudative inflammation, granulomatous inflammation, the mucosal epithelial coating and collagen fibers.Results -The macroscopic analysis showed good coaptation of the edges with a moderate degree of adhesion between the intestines and omentum three to 21 days after surgery. The microscopic evaluation revealed exudative inflammation with neutrophils and fibrin, which ranged from mild to moderate until the 14th day; granulomatous inflammation with macrophages, multinucleated giant cells and epithelioid cells were more evident at 14th day for the cotton, presence of granulation tissue (fibroblasts) and collagen fibers, a moderate way, from the 7th for the three threads. Conclusion -All three threads showed similar behavior and thus they can be indicated for anastomoses of the small intestine.RESUMO -Racional -Nos últimos anos muitos fios de sutura foram desenvolvidos e depois abandonados. Até hoje não foi encontrado um fio cirúrgico ideal aos intestinos ou a outros tecidos de um modo geral, tornando sua escolha tarefa difícil. Objetivo -Avaliar macro e microscopicamente a cicatrização de anastomoses do intestino delgado de cães, utilizando suturas com fios de poliglecaprone 25; poliglactina 910 e algodão. Métodos -Vinte cães machos adultos foram operados e submetidos a três anastomoses no intestino delgado empregando a técnica extramucosa com pontos separados. Foram utilizados os três tipos fios e as anastomoses foram analisadas em diferentes períodos no pós-operatório: grupo I -três dias; grupo II -sete dias; grupo III -14 dias; grupo IV -21dias. A análise macroscópica consistiu em avaliar a presença ou não de peritonite, aspecto das anastomoses e aderências. Os estudos histológicos das anastomoses, empregando a hematoxilina e eosina e o tricrômico de Masson analisaram a inflamação exsudativa, inflamação granulomatosa, o revestimento epitelial da mucosa e as fibras colágenas. Resultados -Na avaliação macroscópica os fios apresentaram boa coaptação das bordas com moderado grau de aderência entre alças e omento do 3º ao 21º dia do pós-operatório. A avaliação microscópica mostrou inflamação exsudativa com neutr...

Comparison between poliglecaprone and chitosan absorbable sutures in laparorrhaphy and cecorrhaphy in rabbits

“…Similar behavior was identified in the intestinal repair, because, from the 15th postoperative day on, the inflammatory process induced by the CG and PG yarns also resulted in a granulomatous process of the foreign body type, mediated mainly by macrophages and discrete giant cells, with moderate fibrosis. Similar results have been described in other studies …”

“…However, visceral interaction with the omentum was not identified, possibly because it comprises a small anatomical structure in the rabbit, a fact also described in another study . Adhesions have also been observed in other studies with PG yarn, either for ligature of the ovarian pedicles and uterine body in felines or cecorrhaphy in rats and dogs . In a study comparing the CG yarn and catgut in hysterorrhaphy in sheep, no adhesions were observed in raffias with CG yarn, but the problem was identified when catgut was used .…”

“…Thus, the analyses of the macroscopic and microscopic findings of this study suggest that the CG yarn, despite the small number of experiments, is a promising yarn. As PG is standardized for different types of sutures and the CG yarn triggered similar tissue responses, the conclusion is that it has great potential to be used as quality surgical yarn.…”

The aplication of cyanoacrilate surgical glue on skin suture in rats

“…Nonabsorbable sutures may remain longer in the surgical site causing chronic inflammation and higher chances of infecitions 4 .…”

Intra-abdominal complications following intestinal anastomoses by suture and staple techniques in dogs

“…Various suture materials and patterns have been examined in the context of intestinal anastomoses. 5–7,13–15 Single-layer appositional closures are preferred to inverting or everting patterns, as submucosal apposition has been shown to promote primary healing of the intestinal wall, whereas inverted or everted closures require second-intention healing and can increase the risk of luminal stenosis or anastomosis site leakage, respectively. 14,16,17 Outcomes following the use of interrupted and continuous suture patterns have been evaluated, and the incidence of leakage is comparable between these methods (1/26 [4%] and 1/57 [2%], respectively).…”