Transdiaphragmatic blockage of the lymphatic may reduce bacterial translocation

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.

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). 1 x 109 cfu/m/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, 1 x 109 cfu/ml/kg E Coli was injected intraperitoneally.

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.

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.