Effects of different suture materials on safety of colonic anastomosis in an experimental model of peritonitis

The risk of leakage from an anastomosis is higher in large intestine in comparison to the other parts of gastrointestinal trackt due to the presence of large amount of pathogen microorganisms and high collagenase enzyme activity in large intestine. In general surgery clinics, in both elective and emergent colon operations primary anastomosis is avoided during operations especially on the left colon, and multi-step procedures are preferred if there is a dirty abdomen. The aim of this experimental study was to compare different suture materials in terms of anastomosis safety in the left colonic anastomosis in presence of peritonitis.This study was conducted in the experimental research center at Fırat University on 21 Wistar-Albino rats by dividing them in 3 groups of equal numbers. After median laparotomy, the whole layer of left colon was cut 2 cm over the pelvic peritoneum. The faeces within the lumen was spread around the injury for fecal contamination. Then, two layers (fasia and skin) of the abdomen were closed with 3/0 silk. 1 day later, the abdomen was opened again under general anesthesia. The abdomen was washed with SF before starting colonic anastomosis. For colonic anastomosis; vicryl + silk was used in the 1st group rats, PDS was used in the 2nd group rats, and coated vicryl plus antibacterial suture and silk was used in the 3rd group rats.Tissue hydroksiproline, anastomosis bursting pressures and histopathologic findings on the anastomosis line were evaluated on the 10th postoperative day by performing relaparatomy. The highest anastomosis bursting pressure was found in Group III (p<0.05). The highest tissue hydroksiproline level was found in Group III (p<0.005 Group I-III, Group II-III). When histopathologic findings were evaluated by comparing three groups, the healing of the intestine tissue score was found to be highest in Group III (p<0.005 Group I-III).Consequently, it was observed that using antibacterial suture increased resection safety in the presence of peritonitis and anastomosis safety in primary anastomosis.