Analysis of early morphological and functional perivulnar changes in the mucosa of the cecum after suturing with different surgical threads
DOI:
https://doi.org/10.15574/PS.2024.82.43Abstract
The correct choice of suture material is the key to successful treatment in abdominal surgery, particularly pediatric surgery. Given this, experimental studies on the effect of sutures made with different surgical threads are one of the most urgent surgery needs.
The aim - to conduct a comparative analysis of early morphological and functional changes in the perivulnar region of the mucosa of the rabbit cecum after suturing with polyglactin-910 and polycaprolactone modified with L-arginine.
Materials and methods. The study was conducted on 25 rabbits aged 8-10 months in compliance with all bioethical standards and recommendations. The control group consisted of 5 animals; the first experimental group, in which synthetic surgical polyfilamentous absorbable suture polyglactin-910 was used to close the wound defect, and the second experimental group, in which monofilamentous absorbable suture polycaprolactone modified with L-arginine was used to close the wound defect, consisted of 10 rabbits each. All stages of surgical access and sampling of intact cecal wall tissues were performed in the control group. The rabbits of the experimental groups underwent colotomy followed by suturing of the large intestine with appropriate suture material. Each experimental group was divided into two subgroups (5 rabbits in each), in which the condition of the perivulvar region was studied on days 3 and 7, respectively. The animals were not euthanised; during the second operation, tissues of the cecum were taken from the sutured area and the formed scar at the appropriate time. Histological, semi-thin serial sections, electron microscopic, morphometric, and statistical methods were used.
Discussion. The average thickness of the cecal mucosa after colotomy increased significantly on days 3-7 when using both surgical threads, but when using polycaprolactone modified with L-arginine, the above indicator was 63.06% and 22.46% lower, respectively, due to a decrease in hyperhydration of the connective tissue component of the mucosa, leukocyte infiltration in the perivulnar area and acceleration of reparative processes.
Conclusions. Polycaprolactone modified with L-arginine has a positive effect on the course of morphological and functional processes in the perivulnar region of the rabbit cecum's mucosa. In terms of its characteristics, it is not worse than polyglactin-910.
No conflict of interests was declared by the authors.
References
Borchiellini P, Rames A, Roubertie F, L'Heureux N, Kawecki F. (2023). Development and characterization of biological sutures made of cell-assembled extracellular matrix. Biofabrication. 15(4): 045018. https://doi.org/10.1088/1758-5090/acf1cf; PMid:37595608
Dikhtenko TH, Levkov AA, Kostenko VO. (2013). Impact of L-arginin immobilized on surgical suture material on the oxidation metabolism in the periwound tissues of the operated small bowel. Klin Khir. (9):66-99.
El-Rashidy NM, El-Bakary MA, Omar E, El-Sayed NM, Hamza AA. (2022). Phase estimation for investigating the optical and mechanical properties of Monocryl suture for soft tissue approximation and ligation. Microsc Res Tech. 85(10): 3455-3465. https://doi.org/10.1002/jemt.24201; PMid:35804492
Hryn VH, Drabovskiy VS, Sytnik DA, Riabuschko MM, Bilash SM, Gonzhak BI. (2022). Peculiarities of morphoetiopathogenesis of acute appendicitis and consequences after appendectomy. Wiad Lek. 75(6): doi: 1492-1499. https://doi.org/10.36740/WLek202206112; PMid:35907222
Kostenko V, Akimov O, Gutnik O, Kostenko H, Kostenko V, Romantseva T et al. (2023). Modulation of redox-sensitive transcription factors with polyphenols as pathogenetically grounded approach in therapy of systemic inflammatory response. Heliyon. 9(5): e15551. https://doi.org/10.1016/j.heliyon.2023.e15551; PMid:37180884 PMCid:PMC10171461
Mazy D, Ma Z, Chung-Tze-Cheong C, Lamer S, Li J, Nault M-L. (2023). Modification of the properties of a suture thread with a tough gel coating: A baseline ex-vivo study. J Orthop Res. 41(8): 1815-1820. https://doi.org/10.1002/jor.25514; PMid:36610018
McDonald CC, Baird RL. (1985). Vicryl intestinal anastomosis. Analysis of 327 cases. Dis Colon Rectum. 28(11): 775-776. https://doi.org/10.1007/BF02555474; PMid:3902412
Munnangi P, Ali ASM, Deva Sh, Kushwaha V, Srivastava Sh, Boini A et al. (2023). Post-surgical Outcomes of Different Surgical Techniques in Hirschsprung's Disease: A Literature Review. Cureus. 15(10): e47012. https://doi.org/10.7759/cureus.47012; PMid:37965402 PMCid:PMC10642618
Pronina OM, Bilash SM, Кobeniak MM, Koptev MM, Pirog-Zakaznikova AV, Onipko VV, Ischenko VI. (2021). Morphometric features of the structural components of the hemomicrocirculatory bed in the perivulnar region of the caecum in wound defect sutured with polyfilament suture material. Wiad Lek. 74(6): 1382-1388. https://doi.org/10.36740/WLek202106118; PMid:34159924
Skripnikov NS, Kostenko VA, Pronina EN, Romantsev AI. (1997). Morphological and metabolic changes in tissues during surgical suture implantation. Klin Khir. (11-12): 78-81.
Skrypnyk I, Maslova G, Lymanets T, Gusachenko I. (2017). L-arginine is an effective medication for prevention of endothelial dysfunction, a predictor of anthracycline cardiotoxicity in patients with acute leukemia. Exp Oncol. 39(4): 308-311. https://doi.org/10.31768/2312-8852.2017.39(4):308-311; PMid:29284775
Taran OV, Solovyova NV, Kostenko VO. (2022). Effect of laparotomy and lipopolysaccharide-induced systemic inflammatory response on metabolic disorders in rats. Fiziol Zh. 68(3): 35-43. https://doi.org/10.15407/fz68.03.035
Uzunlu O, Aydin E, Çomut E, Avcı E, Şenol H. (2023). The comparison of the suture materials on intestinal anastomotic healing: an experimental study. Ulus Travma Acil Cerrahi Derg. 29(9): 956-962. https://doi.org/10.14744/tjtes.2023.86579; PMid:37681730 PMCid:PMC10560814
Wilson DJ, Bordoni B. (2023). Embryology, Bowel [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. URL: https://www.ncbi.nlm.nih.gov/books/NBK545247/.
Wu E, Allen R, Bayne C, Szabo R. (2023). Prospective randomized controlled trial comparing the effect of Monocryl versus nylon sutures on patient- and observer-assessed outcomes following carpal tunnel surgery. J Hand Surg Eur. 48(10): 1014-1021. https://doi.org/10.1177/17531934231178383; PMid:37293819 PMCid:PMC10616990
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