Intraperitoneal BromAc(®) Does Not Interfere with the Healing of Colon Anastomosis

SIMPLE SUMMARY: The drug BromAc(®) has been used in the treatment of pseudomyxoma peritonei, a rare peritoneal cancer. Often, patients with pseudomyxoma peritonei require colon resection with reconnection. Hence, we investigated whether BromAc(®) affects the healing of bowel wounds using a rat model. After colon-resection surgery, BromAc(®) was administered to a group of rats. Another group (control) of rats received saline. The colons were then left to heal for different time intervals. Next, the colons were assessed for healing using the burst-pressure test, whilst the effect of the BromAc(®) on the internal organs was investigated with histology. The results showed no significant differences in the healing of the colon wounds between the BromAc(®)-treated and the control rats. In addition, there was no difference in internal organ histology between the BromAc(®)-treated rats and the controls. Hence, the administration of intraperitoneal BromAc(®) is safe for the healing of colon resection. ABSTRACT: A combination of bromelain and acetylcysteine, BromAc(®), is an efficient intraperitoneal mucolytic for thick mucus secreted in pseudomyxoma peritonei (PMP). Patients with PMP quite often undergo colon anastomosis. Hence, we investigated the effect of the intraperitoneal delivery of BromAc(®) on colon-anastomosis healing in a rat model. Sixteen Wistar rats were divided into two groups (N = 8). The controls received intraperitoneal saline after anastomosis, whilst the other group received BromAc(®). They were monitored for body-weight and general health parameters. Half the rats in each group (N = 4) were culled at 4 or 13 days post-surgery for assessment. The healing process of the tissues was assessed by burst pressure and collagen density with histology to assess the integrity of the internal organs. The results indicated that there was a similar pattern of weight fluctuation during the experiment, although the rats treated with the BromAc(®) showed slightly greater weight loss during the first 4 days. Although the burst pressure was similar in both groups, the BromAc(®) group at day 13 showed a slightly higher burst pressure, which was complemented by a higher collagen density (albeit not statistically significant). The histology of the internal organs was comparable to those of the controls. This study indicates that the intraperitoneal delivery of BromAc(®) in a rat model does not interfere with the healing process of colonic anastomosis.