Do low-molecular-weight heparins influence the healing process in colon anastomosis?

Anastomosis leakage is one of the most serious complications of colorectal surgery. A role for extracellular matrix remodelling in the healing process of the colon wall has been recently postulated. Changes in matrix metalloproteinase (MMP) activity in the intestinal wall occurring prior to elective resection and primary anastomosis appear to be responsible for dehiscence leading to anastomosis.

[Extracellular matrix metalloproteinases. Part II].

Remodeling of extracellular matrix is possible due to activity of specific, skilled proteolytic enzymes present in connective tissue. Metalloproteinases (MMPs) are involved most of physiological and pathological processes in human body. To date 28 enzymes have been identified and 23 in humans.

[Matrix metalloproteinases. Part I].

Metalloproteinases (MMPs) are the extracellular matrix enzymes indispensable in physiological and pathological matrix remodeling. They are produced intracellulary as endopeptidases and secreted to the extracellular space. Under normal conditions MMPs are present in tissues at low levels which increases dramatically during any changes.