A novel approach for repairing of intestinal fistula using chitosan hydrogel

Intestinal fistula is associated with high morbidity and difficult to manage. Many fistulas require surgical treatment, which usually consists of segmental resection. In this study, using a rat model, the effectiveness of chitosan hydrogel as an intestinal fistula repair agent was investigated. Twenty rats underwent laparotomy under general anesthesia. The antimesentric portion of the cecum was incised (1 cm) and sutured to the abdominal wall. Chitosan hydrogel was applied daily to the fistula until it was completely closed. Blood samples taken from all animals were analyzed. After sacrifice, the cecum was removed and histopathologic investigation was performed. Spontaneous closure of the intestinal fistula was observed in all animals for both the control and chitosan hydrogel groups. Healing in the chitosan hydrogel group healing was faster than that in the control group. Blood analysis revealed significant differences between the chitosan hydrogel and control groups with regard to the total protein, albumin, total cholesterol and HDL before the surgery versus that on the day of sacrifice. Pathologic investigation also showed greater healing in the chitosan hydrogel group than the control group. This preliminary study showed the potential of chitosan hydrogel for repair of intestinal fistula. However further studies must be performed before we can approve testing chitosan hydrogel for intestinal fistula repair in humans.