The effect of bioabsorbable (fibrillar) and fibrin glue on the number of macrophages and fibroblasts in Wistar rats with gastric perforation compared to the omental patch method

Abstract

 Background: Gastric perforation covers 25-30% of acute abdomen in the ER and has high mortality and morbidity rate. Surgery is the primary treatment of gastric perforation. The omental patch is commonly used to close the gastric perforation. One method is to use bioabsorbable material glued with fibrin glue. This study aims to determine the effect of bioabsorbable material as a sutureless technique in wound healing of gastric perforation.Method: A true laboratory experimental post-test only control group design using a single-blind technique was conducted among 20 Wistar rats. They were divided into 2 random groups, 10 fibrillar and fibrin glue group and 10 omental patch group. Perforation was made by forming a small hole with a diameter of 0.5 cm using a punch biopsy. The microscopic examination with Hematoxylin-eosin staining was carried out for the number of macrophages and fibroblasts from the gastric perforation site. Data were analyzed using SPSS version 16 for Windows.Result: The average number of fibroblasts produced by the fibrillar and fibrin glue group was 7.5 and 5.4 in omental patch group. Based on the result of  T-test (fibroblasts), it was obtained that there was a significant difference (H1 is accepted) in the number of fibroblasts produced using fibrillar and fibrin glue compared to the omental patch method (P<0.001). The average number of macrophages in fibrillar and fibrin glue group was 4 and 3 in omental patch group. Based on T-test, it was found a significant difference in the number of macrophages produced using fibrillar and fibrin glue compared to the omental patch method (P<0.05)Conclusion: The administration of fibrillar and fibrin glue biomaterials in the closure of gastric perforation increased the number of macrophages and fibroblast cells better than the omental patch method.