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Doxycycline-coated sutures improve mechanical strength of intestinal anastomoses

Pasternak, Bjoern; Rehn, Martin LU ; Andersen, Line; Agren, Magnus S.; Heegaard, Anne-Marie; Tengvall, Pentti and Aspenberg, Per (2008) In International Journal of Colorectal Disease 23(3). p.271-276
Abstract
Background and aims After resection and repair of the intestines, tissue degradation leads to weakening of the repair site and 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. Methohds and methods Implementing a novel method for the coating of biomaterials, we coated sutures with a cross-linked fibrinogen film and bound the MMP inhibitor doxycycline into this film. The sutures were then used in... (More)
Background and aims After resection and repair of the intestines, tissue degradation leads to weakening of the repair site and 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. Methohds and methods Implementing a novel method for the coating of biomaterials, we coated sutures with a cross-linked 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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
suture, leakage, anastomotic, wound dehiscence, colon, matrix metalloproteinase (MMP)
in
International Journal of Colorectal Disease
volume
23
issue
3
pages
271 - 276
publisher
Springer
external identifiers
  • wos:000252482700007
  • scopus:38649131483
ISSN
1432-1262
DOI
10.1007/s00384-007-0401-0
language
English
LU publication?
yes
id
9e0e0f17-c497-4dc0-89ed-c48e0d46695b (old id 1199882)
date added to LUP
2008-09-11 13:10:03
date last changed
2017-10-22 03:56:06
@article{9e0e0f17-c497-4dc0-89ed-c48e0d46695b,
  abstract     = {Background and aims After resection and repair of the intestines, tissue degradation leads to weakening of the repair site and 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. Methohds and methods Implementing a novel method for the coating of biomaterials, we coated sutures with a cross-linked 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.},
  author       = {Pasternak, Bjoern and Rehn, Martin and Andersen, Line and Agren, Magnus S. and Heegaard, Anne-Marie and Tengvall, Pentti and Aspenberg, Per},
  issn         = {1432-1262},
  keyword      = {suture,leakage,anastomotic,wound dehiscence,colon,matrix metalloproteinase (MMP)},
  language     = {eng},
  number       = {3},
  pages        = {271--276},
  publisher    = {Springer},
  series       = {International Journal of Colorectal Disease},
  title        = {Doxycycline-coated sutures improve mechanical strength of intestinal anastomoses},
  url          = {http://dx.doi.org/10.1007/s00384-007-0401-0},
  volume       = {23},
  year         = {2008},
}