Grundlagen und Biologie der Anastomosenheilung

Meyer, G.; Lang, R. A.; Prodinger, P.M.; Stier, Christine

doi:10.1055/s-2007-960735

Cited by 2 publications

(4 citation statements)

References 58 publications

(87 reference statements)

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“…Second, in this model, full thickness stitches were used not taking into account the alignment of different bowel layers. According to a past study, this model represents secondary wound healing, as full thickness stitches result in non-alignment of bowel layers which leads to an intestinal wound filled with necrosis, debris and bacteria, which the body must clear before the intestinal layers can heal, whereas primary wound healing, where bowel layers are aligned, would lead to less necrosis, granulation tissue and abscesses resulting in faster and better wound healing than secondary wound healing 35 . The best technique to perform an intestinal anastomosis is still a topic of debate and multiple studies have investigated multiple techniques without a clear conclusion.…”

Section: Discussionmentioning

confidence: 99%

Histology and transcriptome insights into the early processes of intestinal anastomotic healing: a rat model

van Helsdingen,

Wildeboer,

Zafeiropoulou

et al. 2023

BJS Open

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Background Understanding the early processes underlying intestinal anastomotic healing is crucial to comprehend the pathophysiology of anastomotic leakage. The aim of this study was to assess normal intestinal anastomotic healing and disturbed healing in rats to investigate morphological, cellular and intrinsic molecular changes in the anastomotic tissue. Method Anastomoses were created in two groups of Wistar rats, using four sutures or 12 sutures to mimic anastomotic leakage and anastomotic healing respectively. At 6, 12, 24 hours and 2, 3, 5 and 7 days, anastomotic tissue was assessed macroscopically using the anastomotic complication score and histologically using the modified Ehrlich–Hunt score. Transcriptome analysis was performed to assess differences between anastomotic leakage and anastomotic healing at the first three time points to find affected genes and biological processes. Results Ninety-eight rats were operated on (49 animals in the anastomotic leakage and 49 in the anastomotic healing group) and seven rats analysed at each time point. None of the animals with 12 sutures developed anastomotic leakage macroscopically, whereas 35 of the 49 animals with four sutures developed anastomotic leakage. Histological analysis showed increasing influx of inflammatory cells up to 3 days in anastomotic healing and up to 7 days in anastomotic leakage, and this increase was significantly higher in anastomotic leakage at 5 (P = 0.041) and 7 days (P = 0.003). Transcriptome analyses revealed large differences between anastomotic leakage and anastomotic healing at 6 and 24 hours, mainly driven by an overall downregulation of genes in anastomotic leakage. Conclusion Transcriptomic analyses revealed large differences between normal and disturbed healing at 6 hours after surgery, which might eventually serve as early-onset biomarkers for anastomotic leakage.

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Section: Discussionmentioning

confidence: 99%

Histology and transcriptome insights into the early processes of intestinal anastomotic healing: a rat model

van Helsdingen,

Wildeboer,

Zafeiropoulou

et al. 2023

BJS Open

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“…Similar to general wounds, anastomotic healing occurs in three overlapping phases: (1) hemostasis and inflammation; (2) proliferation or granulation; and (3) remodeling or maturation, but in a slightly faster fashion [ 83 , 89 ]. The hemostasis and inflammation phase occurs in the first 4 to 5 days characterized by the stabilization of the fibrin clot and the infiltration of inflammatory cells [ 89 ]. The following proliferative phase continues for about two weeks to regenerate granulation tissue through collagen deposition, fibroblast proliferation, and neovascularization [ 82 , 89 ].…”

Section: Anastomotic Leakmentioning

confidence: 99%

“…The hemostasis and inflammation phase occurs in the first 4 to 5 days characterized by the stabilization of the fibrin clot and the infiltration of inflammatory cells [ 89 ]. The following proliferative phase continues for about two weeks to regenerate granulation tissue through collagen deposition, fibroblast proliferation, and neovascularization [ 82 , 89 ]. The GI wall layer completely reorganizes and stabilizes in the final remodeling phase, usually two weeks post-surgery [ 89 ].…”

Section: Anastomotic Leakmentioning

confidence: 99%

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Advances in Hydrogel Adhesives for Gastrointestinal Wound Closure and Repair

Grinstaff

2023

Gels

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Millions of individuals undergo gastrointestinal (GI) tract surgeries each year with common postoperative complications including bleeding, perforation, anastomotic leakage, and infection. Today, techniques such as suturing and stapling seal internal wounds, and electrocoagulation stops bleeding. These methods induce secondary damage to the tissue and can be technically difficult to perform depending on the wound site location. To overcome these challenges and to further advance wound closure, hydrogel adhesives are being investigated to specifically target GI tract wounds because of their atraumatic nature, fluid-tight sealing capability, favorable wound healing properties, and facile application. However, challenges remain that limit their use, such as weak underwater adhesive strength, slow gelation, and/or acidic degradation. In this review, we summarize recent advances in hydrogel adhesives to treat various GI tract wounds, with a focus on novel material designs and compositions to combat the environment-specific challenges of GI injury. We conclude with a discussion of potential opportunities from both research and clinical perspectives.

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Grundlagen und Biologie der Anastomosenheilung

Cited by 2 publications

References 58 publications

Histology and transcriptome insights into the early processes of intestinal anastomotic healing: a rat model

Histology and transcriptome insights into the early processes of intestinal anastomotic healing: a rat model

Advances in Hydrogel Adhesives for Gastrointestinal Wound Closure and Repair

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