Antibiotical prophylaxis in rats undergone intestinal anastomosis using methylprednisolone
Keywords:
surgical anatomosis, denal cortex hormone, corticoids, amicacina, antibiotics, methylprednisolone, inbrid strains rats, ileum, intestinesAbstract
High incidence of anastomotic abscesses is registered in animals treated with corticoids. In an attempt to confirm this statement and to study a prophylatic antibiotic scheme, with the objective of reducing the rate of this kind of complication, it was tested in vitro and later in vivo an antibiotic scheme that could Prevent anastomotic abscess formation in rats under the use of methylprednisolone (MP). Firstly, 20 Wistar rats underwent an ileo-ileal anastomosis and were divided in two groups. The first one (group I), was considered the control group and each animal received 1 ml of intramuscular 0,9% SF, from one day before surgery until three days after, when the rats were sacrificed. The second group (group II) received intramuscular MP (10 mg/kg/day), in the same scheme of control group. All rats that received corticoids presented anastomotic abscess. The antibiogram of these abscess showed that Amicacin is the most sensitive antibiotic. Secondly, 10 rats (group III) were submitted to the same procedure as ingroup II, but also receiving daily doses of Amicacin (20 mg/kg/day) in a 12/12 hour basis, from right after surger until they were sacrificed. Anastomotic abscess rate was 80% lower. It was concluded that systemic use of corticoids favors anastomotic abscess formation and the prophylatic use of antibiotics decreases the occurrence of this complication.
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References
ASZODI, A., PONSKY, J.L. Effects of corticosteroid on the healing bowel anasomosis. American Surgeon, Philadelphia, v.50, p.546-548, 1984.
CASTOR, C.W. The effects of chronic glucocortccoid excess on human connective tissue cells in vitro. Journal Laboratory and Clinicai Medicine, St. Louis, v.65, n.3, p.490-499, 1965.
DIPETRILLO, T., LEE, H., CUTRONEO, K.R. Anti-inflamatory adrenal steroids that neither inhibit skin collagen synthesis nor cause dermal atrophy. Archives of Dermatology, Chicago, v.120, p.878-883, 1984.
HOUSTON, K.A., ROTSTEIN, O.D. Fibrin sealant in high-risk colonic anastomoses. Archives Surgery, Chicago, v.123, p.230-4, 1988.
IRVIN, T.T. Collagen metabolism in infect colonic anastomoses. Surgery, Gynecology and Obstetrics, Chicago, v.143, p.220-224, 1976.
KLEIN, L., CHANDRARAJAN, J. Collagen degradation in rat skin but not in intestine during rapid growth: effect on collagen types I and III from skin. Proceedings of the National Academy ofSciences, Washington, v.78, n.4, p.1436-1439, 1977.
LAATO, M., HEINO, J., KAHARI, V., NIINIKOSKI, J., GERDIN, B. Epiderma! growth factor (EGF) prevents methylprednisolone induced inhibition of wound healing. Journal of Surgical Research, New York, v.47, p.354-359, 1989.
MARTINS, A., GUIMARÃES, A.S., FERREIRA, A.L. Efeito dos corticosteróides na cicatrização de anastomoses intestinais. Acta Cirúrgica Brasileira, São Paulo, v.7, n.l, p.30, 1992.
MASTBOOM, W.J.B., HENDRIKS, T., DE MAN, B.M., DE BOER, H.H.M. Influence of methylprednisolone on the healing of intestinal anastomoses in rats. British Journal of Surgery, London, v.78, p.54-56, 1991.
PHILIPS, J.D., KIM, C.S., FONKALSRVD, E.W., ZENG, H., DINDAR, H. Effects of chronic corticosteroids and vitamin A on the healing of intestinal anastomoses. American Journal of Surgery, v.163, p.71-76, 1992.
SALMELA, K., AHONEN, J. The effect of methylprednisolone and vitamin A on wound healing. Acta Chirurgica Scandinavica, Stockholm, v.147, p.307-312, 1981.
SCHROCK, T.D., DEVENEY, C.W., DUNPHY, J.E. Factors contributing to leakage of colonic anastomoses. Annals ofSurgery, Philadelphia, v.177, p.513-518, 1973.
YAMAKAWA, T., PATIN, C.S., SOBEL, S., MORGENSTERN, L. Healing of colonic anastomoses following resection for experimental "diverticulitis". Archives of Surgery, Chicago, v.103, p.17-20, 1971.
