Comparison of Colonic Anastomosis Using Dry Amnion Membrane and Fibrin Glue in Intraperitoneal Infection Condition Assessed from Tissue Hydroxyproline Level Measurement (Study on Wistar Rat)
Keywords:colonic anastomosis, peritonitis, fibrin glue, dry amniotic membrane, collagen, hydroxyproline
Background : Anastomotic leak in the colon is one of the causes of high morbidity and mortality in infectious
cases. The morbidity and mortality rates in patients with colonic anastomotic leakage range from 7–39%.
Various efforts have been made to prevent leakage, such as changing suture techniques and using additional
materials. Materials such as fibrin glue and amniotic membranes are gaining popularity in the wound healing
Purpose : To compare the use of dry amniotic membrane and fibrin glue in colonic anastomosis in
intraperitoneal infection assessed with tissue hydroxyproline level measurement.
Method : This study is an experimental. The subjects were divided into 3 groups, group I (anastomosis using
a simple interrupted suture only), group II (anastomosis and was applied with dry amniotic membrane) and
group III (anastomosis using a simple interrupted sutureand was applied with fibrin glue). The anastomotic
segment was taken and made into homogenate, then measured for the hydroxyproline level.
Result : The study was conducted on 27 Wistar rats, male rats that have been aged 10-12 weeks with the
weight of 250-300 grams. It was obtained the differences in average levels hydroxyproline in the group I
= 2157.41 (± SD = 478.60), group II = 2887.40 (± SD = 688.49) and group III = 2224.59 (± SD = 416.63).
ANOVA test at hydroxyproline samples showed that P <0.05 (0.015) means that there are statistically
significant differences in the levels of hydroxyproline in all three groups of samples. Post Hoc test of ANOVA
showed that the levels of hydroxyproline in the group II (Interrupted suture + Dry amniotic membrane) has
the most high mean difference with the significance of p<0.05 means that the levels of hydroxyproline in the
group is most significant.
Conclusion : Based on the results of the study, it can be concluded that the use of the dry amniotic membrane
was better than fibrin glue of colonic anastomosis in conditions of intra-peritoneal infection, there was an
increase in hydroxyproline levels of colonic anastomosis tissue applied in dry amniotic membrane with
statistically significant results.
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