BACKGROUND: The strength of intestinal anastomoses is relatively low in the first days after operation, possibly as a result of localized degradation of the supporting matrix by enzymes from the matrix metalloproteinase (MMP) family. The aim of this study was to examine whether doxycycline, a drug known to inhibit MMP activity, could enhance anastomotic strength. METHODS: Male Wistar rats received anastomoses in both ileum and colon. From the day before operation onwards, animals were treated daily with doxycycline (orally or subcutaneously) in a dose of 10 mg/day or with saline only. Rats were killed 1, 3, or 5 days after operation, and anastomotic bursting pressure and breaking strength were measured. At day 3, anastomotic hydroxyproline levels were measured, MMP (gelatinase) activity was analyzed by gelatin zymography, and anastomotic histology was examined. RESULTS: Doxycycline enhanced wound strength, but only at day 3, when it was at its lowest. Subcutaneous administration of 10 mg/day increased median colonic and ileal breaking strength by 27% (P =.0019) and 104% (P =.0376), respectively. Colonic bursting pressure was increased by 93% (P =.0002). Wound histology was similar in experimental and control groups. CONCLUSIONS: Administration of doxycycline enhances anastomotic strength and should be investigated further as a means to preserve anastomotic integrity.
BACKGROUND: The strength of intestinal anastomoses is relatively low in the first days after operation, possibly as a result of localized degradation of the supporting matrix by enzymes from the matrix metalloproteinase (MMP) family. The aim of this study was to examine whether doxycycline, a drug known to inhibit MMP activity, could enhance anastomotic strength. METHODS: Male Wistar rats received anastomoses in both ileum and colon. From the day before operation onwards, animals were treated daily with doxycycline (orally or subcutaneously) in a dose of 10 mg/day or with saline only. Rats were killed 1, 3, or 5 days after operation, and anastomotic bursting pressure and breaking strength were measured. At day 3, anastomotic hydroxyproline levels were measured, MMP (gelatinase) activity was analyzed by gelatin zymography, and anastomotic histology was examined. RESULTS:Doxycycline enhanced wound strength, but only at day 3, when it was at its lowest. Subcutaneous administration of 10 mg/day increased median colonic and ileal breaking strength by 27% (P =.0019) and 104% (P =.0376), respectively. Colonic bursting pressure was increased by 93% (P =.0002). Wound histology was similar in experimental and control groups. CONCLUSIONS: Administration of doxycycline enhances anastomotic strength and should be investigated further as a means to preserve anastomotic integrity.
Authors: Mari Nanna Oines; Peter-Martin Krarup; Lars Nannestad Jorgensen; Magnus Sven Agren Journal: World J Gastroenterol Date: 2014-09-21 Impact factor: 5.742
Authors: Klas Holmgren; Pär Jonsson; Christina Lundin; Peter Matthiessen; Jörgen Rutegård; Malin Sund; Martin Rutegård Journal: BJS Open Date: 2022-05-02
Authors: Goran Marjanovic; Eva Jüttner; Axel zur Hausen; Ulrich Theodor Hopt; Robert Obermaier Journal: Int J Colorectal Dis Date: 2009-04-18 Impact factor: 2.571
Authors: Björn Pasternak; Martin Rehn; Line Andersen; Magnus S Agren; Anne-Marie Heegaard; Pentti Tengvall; Per Aspenberg Journal: Int J Colorectal Dis Date: 2007-11-28 Impact factor: 2.571
Authors: L A E Posma; R P Bleichrodt; R M L M Lomme; B M de Man; H van Goor; T Hendriks Journal: J Gastrointest Surg Date: 2009-02-26 Impact factor: 3.452