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Updated: Aug 19, 2026
The C-seal: A Biofragmentable Drain Protecting the Stapled Colorectal Anastomosis from Leakage
Published on: November 4, 2010
Early detection of anastomotic leaks after low anterior resection of the rectum
1Second Surgical Department, Landeskrankenanstalten, Salzburg, Austria.
Purpose:
Lysozyme destroys the mucopolysaccharide chains of the cell wall of gram-negative bacteria. It is a component of local defense and is formed in macrophages. Determination of lysozyme content in the wound seems to be the most reliable method for early recognition of wound infection.
Methods:
In a prospective randomized study on the efficacy of single vs. double staple technique in anterior rectum resection, the effluent from the pelvic drain was examined with regard to its lysozyme activity.
Results:
Lysozyme activity in drained secretion remained stable for more than 24 hours at room temperature. When the single staple technique was used, enzyme activity was sharply increased (mean, 9.6 mg/dl on the first postoperative day) compared with the double staple technique (mean, 5.5 mg/dl on the first postoperative day). The difference was statistically significant (P < 0.0001). Mean lysozyme activity was increased in those patients with clinically (18 mg/dl on the first postoperative day) and radiologically (15.3 mg/dl on the first postoperative day) detected dehiscence (P < 0.0001).
Conclusion:
Lysozyme determination may be reproduced by detection of enzyme stability in drained secretion. Determination of lysozyme content seems to be a new possibility for early recognition of anastomotic dehiscence.
Insights
Lysozyme levels in wound drainage can predict complications after anterior rectum resection. Higher lysozyme activity indicates a greater risk of anastomotic dehiscence, offering early detection of wound infections.
Area of Science:
- Biochemistry
- Surgical Oncology
- Wound Healing
Background:
- Lysozyme is a key enzyme in innate immunity, crucial for defense against Gram-negative bacteria.
- Its presence in wound exudate suggests a role in local defense mechanisms and infection monitoring.
Purpose of the Study:
- To evaluate lysozyme activity in pelvic drain effluent following anterior rectum resection.
- To determine if lysozyme levels can serve as an early indicator of anastomotic dehiscence.
Main Methods:
- A prospective randomized study comparing single vs. double staple techniques in anterior rectum resection.
- Lysozyme activity was measured in pelvic drain effluent over 24 hours at room temperature.
Main Results:
- Lysozyme activity remained stable in drained secretion for over 24 hours.
- Single staple technique showed significantly higher lysozyme activity (9.6 mg/dl) versus double staple (5.5 mg/dl) on postoperative day 1.
- Elevated lysozyme levels correlated with clinically (18 mg/dl) and radiologically (15.3 mg/dl) detected anastomotic dehiscence.
Conclusions:
- Lysozyme determination in drained secretions is a reproducible method.
- Measuring lysozyme content offers a novel approach for the early detection of anastomotic dehiscence.
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