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Intraperitoneally applied gentamicin increases collagen content and mechanical stability of colon anastomosis in rats

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Abstract

Background

Anastomotic leakage remains a serious complication in colorectal surgery, and is being caused by a multitude of factors. Recent reports reveal changes of the extracellular matrix as risk factors as well as gentamicin as a potential agent to influence wound healing. This experimental study was initiated to investigate the influence of intraperitoneally applied gentamicin on colonic anastomotic wound healing and in particular on mechanical stability, overall collagen content and collagen type I/III ratio.

Materials and methods

Sixty Sprague Dawley rats were randomized to one of two groups. In each animal, a standard transverse colonic end-to-end anastomosis was performed. Immediately postoperative, either 5 ml gentamicin (1 ml/kg bodyweight) or NaCl 0.9% was applied intraperitoneally. On postoperative days 3, 5, and 14, ten of the animals in each group were sacrificed. Measurements of the anastomosis bursting pressure were performed on postoperative days 3 and 5. At each explantation time, the collagen per protein ratio, the collagen types I/III ratio, and both the expression of MMP-2, -9, and Ki67 were analyzed.

Results

None of the animals died. None of the rats exhibited clinical evidence of anastomotic leakage. The bursting strength in the gentamicin group was significantly elevated on postoperative day 5. Both the overall collagen content and the collagen type I/III ratio in the gentamicin group were significantly increased 3, 5, and 14 days postoperatively compared to the control group. The expression of MMP-9 was significantly elevated in the gentamicin group both 3 and 5 days postoperatively. In contrast, there were no significant differences in the expression of MMP-9 14 days postoperatively. All investigated samples demonstrated positive staining for MMP-2 and Ki67 without statistically significant differences at any term, respectively.

Conclusions

The present data confirm that intraperitoneally applied gentamicin is able to enhance healing and stability of colonic anastomosis due to an increase of both the overall collagen content and collagen type I/III ratio.

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Acknowledgment

We are grateful to Mrs. Ellen Krott for most excellent and careful assistance during this investigation.

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Authors and Affiliations

  1. Department of Surgery, Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany

    Marcel Binnebösel, Karsten Junge, Daniel A. Kaemmer, Carsten J. Krones, Volker Schumpelick & Uwe Klinge

  2. Joint Institute for Surgical Research, Russian State Medical University, Moscow, Russia

    Svetlana Titkova & Michael Anurov

  3. Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany

    Uwe Klinge

  4. RWTH Aachen University Hospital, Aachen, Germany

    Marcel Binnebösel, Karsten Junge, Daniel A. Kaemmer, Carsten J. Krones, Svetlana Titkova, Michael Anurov, Volker Schumpelick & Uwe Klinge

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  1. Marcel Binnebösel
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Correspondence to Marcel Binnebösel.

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Binnebösel, M., Junge, K., Kaemmer, D.A. et al. Intraperitoneally applied gentamicin increases collagen content and mechanical stability of colon anastomosis in rats. Int J Colorectal Dis 24, 433–440 (2009). https://doi.org/10.1007/s00384-008-0614-x

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  • DOI: https://doi.org/10.1007/s00384-008-0614-x

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