Ann Surg Treat Res.  2017 Sep;93(3):159-165. 10.4174/astr.2017.93.3.159.

Sustained-released mixture of vascular endothelial growth factor 165 and fibrin glue strengthens healing of ileal anastomoses in a rabbit model with intraperitoneal infection

• Li Z
• Wang W
• Wang X
• Jiang L
• Wang F
• Liu Q

• KMID: 2398963
• DOI: http://doi.org/10.4174/astr.2017.93.3.159

Abstract

PURPOSE
To investigate the effects of a sustained-released mixture of vascular endothelial growth factor 165 (VEGF165) and fibrin glue (FG) local administration on postoperative rabbit ileal anastomoses.
METHODS
One hundred twenty-eight male and female New Zealand white rabbits underwent intraperitoneal infection subsequent ileal anastomosis surgery were divided randomly into 4 groups, including 32 animals in each, applied with saline solution, FG, rhVEGF165 and a mixture of rhVEGF165 with FG (VEGF + FG) on the anastomoses, respectively. The incidences of anastomotic leakage were observed. Histopathological examination for inflammatory infiltration, fibroblast proliferation, and capillary vascular proliferation were performed. Then, bursting pressure and hydroxyproline concentrations were assessed in anastomoses sits on postoperative days 3, 5, 7, and 14.
RESULTS
Rabbits in VEGF + FG group had the lowest incidence of leakage (P < 0.05). Histological evaluations revealed that granulation tissue was formed on days 5 after anastomosis; fibroblast proliferation and capillary vascular proliferation were significantly increased on days 7 and 14 in VEGF + FG group. Furthermore, there was a statistically significant difference in the mean bursting pressures between VEGF + FG group and other groups on days 7 and 14 (P < 0.05), and rabbits in VEGF + FG group exhibited a higher concentration than VEGF group (P < 0.05) and FG group (P < 0.05) on day 14.
CONCLUSION
Administration of VEGF165 mixed with FG to ileal anastomosis accelerates wound healing and enhances the anastomosis by increased angiogenesis.

Keyword

Anastomotic leak; Ileum; Vascular endothelial growth factor A; Fibrin tissue adhesive; Delayed-action preparations

MeSH Terms

4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic Acid
Anastomotic Leak
Animals
Capillaries
Delayed-Action Preparations
Female
Fibrin Tissue Adhesive*
Fibrin*
Fibroblasts
Granulation Tissue
Humans
Hydroxyproline
Ileum
Incidence
Male
Rabbits
Sodium Chloride
Vascular Endothelial Growth Factor A*
Wound Healing
4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic Acid
Delayed-Action Preparations
Fibrin
Fibrin Tissue Adhesive
Hydroxyproline
Sodium Chloride
Vascular Endothelial Growth Factor A

Figure

• 

  Fig. 1 Histological appearance of the ileal anastomosis under H&E staining in different groups. (A) Control group (×200), (B) FG group (×200), (C) VEGF group (×200), and (D) VEGF + FG group (×200). VEGF, vascular endothelial growth factor; FG, fibrin glue.

• 

  Fig. 2 Bursting pressures were detected in the anastomosis on postoperative days 3, 5, 7, and 14. Pressures were shown in millimeters mercury column (mean ± standard deviation). *P < 0.05, compared with control group. #P < 0.05, compared with FG group. ΔP < 0.05, compared with VEGF group. VEGF, vascular endothelial growth factor; FG, fibrin glue.

• 

  Fig. 3 Hydroxyproline concentrations were assessed in the anastomosis on postoperative days 3, 5, 7, and 14. Concentrations were shown in millimeters mercury column (mean ± standard deviation). *P < 0.05, **P < 0.01, compared with control group. #P < 0.05, compared with FG group. ΔP < 0.05, compared with VEGF group. VEGF, vascular endothelial growth factor; FG, fibrin glue.

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