PhD

The study was conducted with the objective of evaluating the host
acceptability and healing of processed collagen sheets of animal and aquatic tissue
for reconstruction of experimentally created urinary bladder defects in rabbits and for
reconstruction of urinary bladder in clinical cases in dogs.
The study was conducted in twelve apparently healthy adult New Zealand
White rabbits of either sex weighin~ 2.1 - 3 kg, divided into two groups, I and 11., of
six animals each and in six male dogs (group Ill).
The rabbits were subjected to partial cystectomy followed by cystoplasty
using glutaraldehyde processed canine collagen sheet in group I, diacetyl processed
fish collagen sheet in group 11 and in clinical cases in dogs, cystoplasty using both
the materials.
Tissue samples of urinary bladder harvested from died dogs were made into
sheets, processed and crosslinked with glutaraldehyde at Central Leather Research
Institute, Adayar, Chennai. Fish air bladder collected from larger fresh water fishes
were made into sheets, processed and crosslinked with diacetyl at Central Institute of
Fisheries Technology, Cochin. The collagen sheets were sterilised with gamma
irradiation. The fish collagen sheet was thicker than canine collagen sheet.
All the rabbits were premedicated with atropine sulphate and xylazine
hydrochloride and were anaesthetized using ketamine hydrochloride.
In the rabbits a portion of bladder wall (2 cnr') was removed from dorsal
aspect of fundus close to the vertex. The graft material was fixed at the defects, using
5-0 braided silk in overlapping continuous horizontal mattress sutures. The collagen
sheet effected haemostasis at the bleeding points of surgically created defects.


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IJ
The rabbits of both the groups were kept under observation for a minimum
period of one month.
The animals of both the groups were lethargic and dull on the first
postoperative day and active and alert from second day.
A marginal increase in rectal temperature, pulse rate and gradual decrease in
respiration rate were observed during early postoperative period in all the animals.
A reduction in feed and grass intake, and water consumption was noticed on
the first postoperative day in all the animals and normal feeding and water i~take
were resumed from second postoperative day.
Marginal reduction in haeomoglobin concentration, packed cell volume, total
erythrocyte count, and totalleukocyte count were observed on seventh postoperative
day in haemogram.
Differential leukocyte count showed neutrophilia in both the groups and
decrease in lymphocyte count on seventh postoperative day. Eosinophil, basophil and
monocyte counts showed marginal variations.
During the early period of observation an increase in blood urea nitrogen was
noticed in both the groups, but serum creatinine level did not show any variation. A
marginal increase in serum sodium, potassium and decrease in chloride
concentration, total protein and albumin were noticed during the period of
observation in both the groups.
Intravenous pyelogram during postoperative period showed normal passage
of urine from renal level and normal filling of reconstructed bladder in all the
animals.

III
Gross morphological changes were not observed externally on the bladder or
on the mucosa. Moderate fibrinous adhesions were noticed between grafted site and
adjacent tissues, but mild corded thickening of the mucosa bordering the central
portion of grafted area was observed.
Histomorphological studies by 30th day revealed almost complete
proliferation of mucosa with progressive neovascularisation and inflammatory
reaction in both the groups. The proliferation of blood vessels and inflammatory
reactions were much greater in group 11.
In clinical study in the dogs cystoplasty was done using canine and fish
collagen sheets.
All the dogs were premedicated with triflupromazine hydrochloride and
anaesthetized using thiopentone sodium 'to effect'. The rent on the bladder was
reconstructed by fixing the graft material to the edges of the bladder using 3-0 catgut
in through and through continuous horizontal mattress sutures.
The dogs were kept under observation for 15 days postoperatively.
The animals started feeding on milk from first postoperative day and
gradually attained normal appetite by fourth day.
Animals passed blood tinged urine for two to three days postoperatively.
Urine pH was slightly alkaline for first two days after surgery. The urine samples
were positive for occult blood and protein for first two days. Microscopically urine
sample revealed granular casts, phosphate crystals, epithelial cells, red blood cells
and white blood cells during the observation period.
Straining while urination was observed for the first day in all the dogs but it
ceased from second day.





,
iv
A marginal increase in rectal temperature, pulse rate and respiration rate were
observed during early postoperative period in all the dogs.
A marginal decrease in haemoglobin concentration and increase in packed
cell volume, total erythrocyte count, totallymphocyte count were the salient features
of haemogram during early postoperative period.
Differential leukocyte count showed mild neutrophilia in all the dogs. A
decrease in lymphocyte count was noticed during the early period of observation.
The eosinophil, basophil and monocyte count showed marginal variation during the
period of observation.
During the early period of observation an increase in blood urea nitrogen with
no variation in serum creatinine level were noticed in all the dogs.
Marginal elevation in serum sodium and potassium concentration and
marginal fall in chloride concentration during the early period of observation was
noticed in all the dogs.
A marginal decrease in total serum protein and increase in serum albumin
was noticed in early period of observation. All the dogs regained near normalcy by
15th day postoperatively.
Retrograde cystogram during the postoperative period revealed normal
contour and moderate filling capacity of reconstructed bladder.