Efeitos do campo eletromagnético dinâmico e do adesivo de fibrina, usados separadamente ou em associação, sobre a cicatrização de anastomoses colônicas de ratos

Abstract

The search for factors that assist the healing of intestinal anastomoses and which may decrease the incidence of dehiscence, leakages, fistulas and peritonitis, continues to be the subject of many studies in the literature. Despite medical advances, these complications are still frequent with a high mortality rate. Electromagnetism and fibrin biological adhesive have been used to assist the healing of tissues. This search aims to study the effects of a dynamic electromagnetic field and fibrin glue, used separately or together, on the healing of colonic anastomoses. Forty Wistar rats, adult males weighing between 228g and 282g, were divided into four groups of 10 animals each. In Group I (control) neither an electromagnetic field nor fibrin glue was used. Animals in Group II (field) were exposed postoperatively to an electromagnetic field only (three cycles of two hours duration with intervals of twenty-two hours). In the animals in Group III (glue), the anastomosis was only reinforced with fibrin glue. In Group IV (field + glue), as well as being exposed postoperatively to an electromagnetic field, the animals had also had peroperative reinforcement of the anastomosis with fibrin glue. All animals were subjected to transection of the colon 3cm distal to the cecum, following end-to-end anastomosis with separate stitches. The reoperation in all groups occurred 72 hours after this intervention, and the intestinal segment which contained the anastomosis was resected for study. This segment was subjected to measurement of burst pressure and histological examinations to assess the healing. Statistical analysis of the data showed that the burst pressure values were significantly higher in animals in Groups II, III and IV compared to Group I (p <0.05), but with no difference among them. Histological analysis of fragments of the anastomosis stained with hematoxylin-eosin showed exacerbation of the healing process in animals in Groups II and IV compared to Groups I and III, but with no difference between them (p <0.05). There was also an increase in the proportion of newly formed collagen in Groups II and IV compared to Groups I and III, but without differences between them (p <0.05). It was concluded that exposure to an electromagnetic field alone or in association with the use of fibrin glue on colonic anastomoses in rats increases the burst pressure and the production of collagen, and with the isolated use of fibrin glue there is increased anastomotic burst pressure but no significant histological changes observed in the healing of intestinal anastomosis.