SEARCH

SEARCH BY CITATION

Keywords:

  • anastomotic wound healing;
  • basic fibroblast growth factor;
  • controlled release;
  • gelatin hydrogel;
  • intestinal anastomosis;
  • regenerative medicine;
  • vascularization

Abstract

Anastomotic leakage is a common complication of intestinal surgery. In a trial to resolve this issue, enhancement of anastomotic wound healing was found to be a promising approach. A method for controlled release of basic fibroblast growth factor (bFGF) using a gelatin hydrogel was developed. Here the objective was to investigate the effects of this technology on intestinal anastomotic healing. The small intestine of Wistar rats was cut and end-to-end anastomosis was performed. The rats were then divided into three groups: bFGF group (anastomosis wrapped with a hydrogel sheet incorporating bFGF), PBS group (wrapped with a sheet incorporating phosphate-buffered saline solution) and NT group (no additional treatment). To define the optimal bFGF dose and the hydrogel biodegradability, the degradation profiles of gelatin hydrogels in vivo and histological examinations were performed using gelatin hydrogels with various water contents and bFGF concentrations. The anastomotic wound healing process was evaluated by histological examinations, adhesion-related score and bursting pressure. The optimal water content of the hydrogel and bFGF dose was determined as 96% and 30 µg per sheet, respectively. Application of bFGF significantly enhanced neovascularization, fibroblast infiltration and collagen production around the anastomotic site when compared with the other groups. Bursting pressure was significantly increased in the bFGF group. No significant difference was observed in the adhesion-related score among the groups. No anastomotic obstruction and leakage were observed. Controlled release of bFGF enhanced healing of an intestinal anastomosis during the early postoperative period and is promising for suppressing anastomotic leakage. Copyright © 2013 John Wiley & Sons, Ltd.