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Einfluss der intraperitonealen Applikation von Gentamicin auf die Darmanastomosenheilung in einem Kleintiermodell

  • Verbovsek, Anita
Publication Date
Jan 01, 2010
Publikationsserver der RWTH Aachen University
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Then anastomotic leackage after large bowel surgery still represents a great complication there are multiple efforts to find the causes for this problem. In this experiment we examined by means of an animal test the effect of an intraperitoneally applied gentamicin on the wound healing process after bowel anastomosis. We determined the quality of wound healing by means of an immunohistochemical analysis of multiple parameters which have an influence of the composition of the extracellular matrix respectively represents components of the extracellular matrix. We examined the collagen content, thecollagen type I/III ratio, the matrixmetaloproteinases MMP-2 and MMP-9, the profibrinogen zytokine TGF-beta, the transcription factor Y-box (YB) protein-1 and Ki-67. The determination of these parameters followed on the postoperative days 3, 5 and 14 in two groups to value the quality of the scar. Our present data suggest that gentamicin next to the antibiotic effect is able to improve anastomotic healing. Intraperitoneally applied gentamicin increases mechanical stability of colonic anastomosis in rats in comparison with both increased overall collagen content and an increased collagen type I/III ratio. However, animal experiments,particularly rodent animal midels,have their natural limitations,and results cannot be extrapolated directly to the situation of humans. In particular,the animals con not be reflect any underlying human disease or co-morbidity. In this experiment we could show for the first time that the local application of gentamicin improves the quality of intestinal wound healing, as it is previously shown for the mesh integretion within the abdominal wall. It has to be an issue for further studies to reveal the molecular mechanisms of gentamicin to affect the ECM and in particular the collagen metabolism.

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