In the presence of risk factors, the anastomosis in the small intestine and in the colon are at risk for dehiscence and peritonitis. The apposition of a biological patch around the anastomosis might improve wound healing and therefore might prevent harmful, potentially life-threatening and costy complications. Aim: to verify if Tutomesh® facilitates the functional recovery of the intestinal anastomotic wound area (mucosa) in the pig ileum and colon. Methods: 24 Large White pigs (B.W. 25 kg; age 4-5 months) underwent ileal and colonic anastomosis with or without application of Tutomesh® and compared with healthy (intact) control intestinal segments. At days 2, 7, 14, 30 and 90 following surgery, ileal and colonic mucosa were isolated from similar anastomized and control tracts and mounted in Ussing chambers containing Krebs oxygenated solution at pH 7.4. Electrophysiological parameters, i.e. short circuit current (Isc) and transepithelial resistance (Rt), as markers of mucosal function, were continously measured by a digital voltage clamp system. Results: Ileal mucosa from control showed Isc of -17.10±4.72 μA/cm2 and Rt of 105.91±11.98 Ohm*cm2. In anastomized ileum Isc decreased by 52% and Rt increased by 58% (n=6 tissues); with Tutomesh® the Isc reduction was only 16.3% while Rt increased by 46% (for both n=6; p<0.001 vs. control). In colonic mucosa from 13 control tissues, Isc was -10.67±2.29 μA/ cm2, Rt 140.94±14.38 Ohm*cm2. Colonic Isc and Rt (n=6) remained stable with anastom- osis, while Tutomesh® significantly increased the current by 47.0% (n=7; p<0.001 vs. control). Conclusions: Our observations suggest that transport properties of intestinal mucosa improve significantly with Tutomesh® , a useful resorbable bio-patch which therefore helps the functional recovery of anastomoses, mainly in the ileum. Further studies are ongoing to assess the translational value of Tutomesh® in surgical patients.
The Apposition of a Resorbable Pericardial Bovine Patch (Tutomesh (R)) on Intestinal Anastomoses Improves Functional Mucosal Recovery in Pig Ileum and Colon Assessed by Ussing Chamber Electrophysiological Studies
DEBELLIS, Lucantonio;Testini M;Gurrado A;CROVACE, Antonio;STAFFIERI, FRANCESCO;Bonfrate L;PORTINCASA, Piero
2011-01-01
Abstract
In the presence of risk factors, the anastomosis in the small intestine and in the colon are at risk for dehiscence and peritonitis. The apposition of a biological patch around the anastomosis might improve wound healing and therefore might prevent harmful, potentially life-threatening and costy complications. Aim: to verify if Tutomesh® facilitates the functional recovery of the intestinal anastomotic wound area (mucosa) in the pig ileum and colon. Methods: 24 Large White pigs (B.W. 25 kg; age 4-5 months) underwent ileal and colonic anastomosis with or without application of Tutomesh® and compared with healthy (intact) control intestinal segments. At days 2, 7, 14, 30 and 90 following surgery, ileal and colonic mucosa were isolated from similar anastomized and control tracts and mounted in Ussing chambers containing Krebs oxygenated solution at pH 7.4. Electrophysiological parameters, i.e. short circuit current (Isc) and transepithelial resistance (Rt), as markers of mucosal function, were continously measured by a digital voltage clamp system. Results: Ileal mucosa from control showed Isc of -17.10±4.72 μA/cm2 and Rt of 105.91±11.98 Ohm*cm2. In anastomized ileum Isc decreased by 52% and Rt increased by 58% (n=6 tissues); with Tutomesh® the Isc reduction was only 16.3% while Rt increased by 46% (for both n=6; p<0.001 vs. control). In colonic mucosa from 13 control tissues, Isc was -10.67±2.29 μA/ cm2, Rt 140.94±14.38 Ohm*cm2. Colonic Isc and Rt (n=6) remained stable with anastom- osis, while Tutomesh® significantly increased the current by 47.0% (n=7; p<0.001 vs. control). Conclusions: Our observations suggest that transport properties of intestinal mucosa improve significantly with Tutomesh® , a useful resorbable bio-patch which therefore helps the functional recovery of anastomoses, mainly in the ileum. Further studies are ongoing to assess the translational value of Tutomesh® in surgical patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
