Doxycycline-coated sutures improve mechanical strength of intestinal anastomoses
2008 (English)In: International Journal of Colorectal Disease, ISSN 0179-1958, Vol. 23, no 3, 271-276 p.Article in journal (Refereed) Published
Background and aims: After resection and repair of the intestines, tissue degradation leads to weakening of the repair site and a risk of postoperative leakage. Matrix metalloproteinases (MMPs) are thought to be responsible for collagenolysis in the direct vicinity of surgical sutures in many tissues. Several experimental studies show that MMP-inhibitors administered systemically alleviate postoperative weakening of intestinal anastomoses. We hypothesised that local delivery of MMP-inhibitors would achieve a similar effect.
Methods: Implementing a novel method for the coating of biomaterials, we coated sutures with a crosslinked fibrinogen film and bound the MMP-inhibitor doxycycline into this film. The sutures were then used in a standard rat model for evaluating mechanical properties of colonic anastomoses 3 days after surgery.
Results: The breaking strength of the anastomoses on the critical third day after operation was 17 % higher with doxycycline-coated sutures compared to controls (P=0.026). Energy uptake at failure was enhanced by 20 % (P=0.047).
Conclusion: Drug delivery by means of MMP-inhibitor-coated sutures appears to improve tissue integrity during anastomotic repair and may reduce postoperative complications.
Place, publisher, year, edition, pages
2008. Vol. 23, no 3, 271-276 p.
colon, matrix metalloproteinase (MMP), wound dehiscence, anastomotic leakage, suture
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-11695DOI: 10.1007/s00384-007-0401-0OAI: oai:DiVA.org:liu-11695DiVA: diva2:18119
The original publication is available at www.springerlink.com: Björn Pasternak, Martin Rehn, Line Andersen, Magnus S. Ågren, Anne-Marie Heegaard, Pentti Tengvall and Per Aspenberg, Doxycycline-coated sutures improve mechanical strength of intestinal anastomoses, 2008, International Journal of Colorectal Disease, (23), 271-276 http://dx.doi.org/10.1007/s00384-007-0401-0. Copyright: Springer, www.springerlink.com2008-09-012008-09-012009-08-20