Transdiaphragmatic blockage of the lymphatic may reduce bacterial translocation

Abstract

PURPOSE: Bacterial translocation is a spread of living and non-living bacteria and bacterial end-products, passing over the mucosal barrier distending mesenteric lymph nodes, blood and viscera. DuraSeal(polyglycolic acid glue) has adhesive power and it usually used in brain or spinal surgery . We aimed to show the barrier system effect using experiments, in which intraabdominal infection induced and translocation from diaphragm to thorax is researched. 

METHODS: We used 90 Wistar Albino male rats weighing 200-250 grams in our experiment. Laparotomy was performed to all groups. After laparotomy, intraperitoneal 1 cc physiological saline was given in Group I (control). 1x109 cfu/ml/kg (colony forming unit/mililiter/kilograms) E. Coli was injected intraperitoneally in Group II. In Group III, DuraSeal® (Confluent Surgical, Inc., Waltham, MA) was sprayed on the diaphragm. After waiting for approximately 2 minutes to see the barrier effect, 1x109 cfu/ml/kg E. Coli was injected intraperitoneally. 

RESULTS: For the samples taken intraperitoneally, 100% breeding was determined in all groups except Group 1. While no positive staining was observed in the thoraxes of the rats in Group I and Group III at the first hour, the positive staining ratio in the Group II was 70%. The positivity ratio of Group II was 80% and the ratio was 50% in Group III at the third and sixth hours. Regarding hemoculture E. Coli positivity, there was no proliferation in the hemoculture samples of Group I at all time periods, whereas it was positive in the other groups excluding the first hour. 

CONCLUSIONS: The synthetic hydrogel Duraseal®, which was designed to prevent postoperative fibrosis and air leakage, was able to partially block the translocation of the bacteria to the thorax via lymphatic or directly.