Visualisation and quantification of the effects of surgical humidification on intestinal perfusion and viability in a porcine model

Abstract Cold and poorly oxygenated tissues are known to increase the risk of surgical site infection and anastomotic leaks in gastrointestinal surgery. Especially during laparotomy, the abdominal cavity is exposed to the cold dry operating theatre which may contribute to surgical site evaporative c...

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Main Authors: Mahdi Al-Taher, Eric Felli, Nariaki Okamoto, Maria Rita Rodriguez-Luna, Andrea Baiocchini, Eric Noll, Pierre Diemunsch, Nicole Bouvy, Laurents Stassen, Sophie Diemunsch, Michele Diana
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-14082-0
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author Mahdi Al-Taher
Eric Felli
Nariaki Okamoto
Maria Rita Rodriguez-Luna
Andrea Baiocchini
Eric Noll
Pierre Diemunsch
Nicole Bouvy
Laurents Stassen
Sophie Diemunsch
Michele Diana
author_facet Mahdi Al-Taher
Eric Felli
Nariaki Okamoto
Maria Rita Rodriguez-Luna
Andrea Baiocchini
Eric Noll
Pierre Diemunsch
Nicole Bouvy
Laurents Stassen
Sophie Diemunsch
Michele Diana
author_sort Mahdi Al-Taher
collection DOAJ
description Abstract Cold and poorly oxygenated tissues are known to increase the risk of surgical site infection and anastomotic leaks in gastrointestinal surgery. Especially during laparotomy, the abdominal cavity is exposed to the cold dry operating theatre which may contribute to surgical site evaporative cooling, tissue desiccation, and reduced oxygenation. Surgical humidification, the intraoperative insufflation of warm humidified carbon dioxide into the laparotomy wound, is a local intervention designed to prevent the evaporative cooling and desiccation effects of laparotomy. In this study, we present the first data from a large animal model to visualise and quantify the effects of surgical humidification on intestinal tissue viability and oxygenation during open surgery. Our results demonstrated that surgical humidification significantly improved core and local intestinal temperature. In addition, intestinal local capillary lactate levels used as a surrogate of local tissue oxygenation demonstrated a significant improvement with surgical humidification. Further, surgical humidification showed a significant protective effect against peritoneal and intestinal tissue damage. The use of surgical humidification improved local tissue oxygenation as confirmed with perfusion biomarkers, as well as maintaining core and local temperature repetition. Surgical humidification may help to improve outcomes of abdominal open surgery. Further confirmatory clinical trials are needed.
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spelling doaj-art-de7f9cefaa6b48ebbecc89063367e8c42025-08-20T04:01:51ZengNature PortfolioScientific Reports2045-23222025-08-0115111110.1038/s41598-025-14082-0Visualisation and quantification of the effects of surgical humidification on intestinal perfusion and viability in a porcine modelMahdi Al-Taher0Eric Felli1Nariaki Okamoto2Maria Rita Rodriguez-Luna3Andrea Baiocchini4Eric Noll5Pierre Diemunsch6Nicole Bouvy7Laurents Stassen8Sophie Diemunsch9Michele Diana10Department of colorectal surgery, Tawam HospitalDepartment of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of BernDepartment of Colorectal Surgery, National Cancer Center Hospital EastDepartment of General surgery, Hospital de BarcelonaDepartment of Pathology, San Camillo Forlanini HospitalDepartment of Anesthesia, Intensive Care and Perioperative Medicine, Strasbourg Hautepierre University HospitalDepartment of Anesthesia, Intensive Care and Perioperative Medicine, Strasbourg Hautepierre University HospitalNutrim Research School of Nutrition and Metabolism, Maastricht UniversityNutrim Research School of Nutrition and Metabolism, Maastricht UniversityDepartment of Anesthesia, Intensive Care and Perioperative Medicine, Strasbourg Hautepierre University HospitalMedical Faculty, University of GenevaAbstract Cold and poorly oxygenated tissues are known to increase the risk of surgical site infection and anastomotic leaks in gastrointestinal surgery. Especially during laparotomy, the abdominal cavity is exposed to the cold dry operating theatre which may contribute to surgical site evaporative cooling, tissue desiccation, and reduced oxygenation. Surgical humidification, the intraoperative insufflation of warm humidified carbon dioxide into the laparotomy wound, is a local intervention designed to prevent the evaporative cooling and desiccation effects of laparotomy. In this study, we present the first data from a large animal model to visualise and quantify the effects of surgical humidification on intestinal tissue viability and oxygenation during open surgery. Our results demonstrated that surgical humidification significantly improved core and local intestinal temperature. In addition, intestinal local capillary lactate levels used as a surrogate of local tissue oxygenation demonstrated a significant improvement with surgical humidification. Further, surgical humidification showed a significant protective effect against peritoneal and intestinal tissue damage. The use of surgical humidification improved local tissue oxygenation as confirmed with perfusion biomarkers, as well as maintaining core and local temperature repetition. Surgical humidification may help to improve outcomes of abdominal open surgery. Further confirmatory clinical trials are needed.https://doi.org/10.1038/s41598-025-14082-0SurgeryLaparotomyHumidificationSurgical site infection
spellingShingle Mahdi Al-Taher
Eric Felli
Nariaki Okamoto
Maria Rita Rodriguez-Luna
Andrea Baiocchini
Eric Noll
Pierre Diemunsch
Nicole Bouvy
Laurents Stassen
Sophie Diemunsch
Michele Diana
Visualisation and quantification of the effects of surgical humidification on intestinal perfusion and viability in a porcine model
Scientific Reports
Surgery
Laparotomy
Humidification
Surgical site infection
title Visualisation and quantification of the effects of surgical humidification on intestinal perfusion and viability in a porcine model
title_full Visualisation and quantification of the effects of surgical humidification on intestinal perfusion and viability in a porcine model
title_fullStr Visualisation and quantification of the effects of surgical humidification on intestinal perfusion and viability in a porcine model
title_full_unstemmed Visualisation and quantification of the effects of surgical humidification on intestinal perfusion and viability in a porcine model
title_short Visualisation and quantification of the effects of surgical humidification on intestinal perfusion and viability in a porcine model
title_sort visualisation and quantification of the effects of surgical humidification on intestinal perfusion and viability in a porcine model
topic Surgery
Laparotomy
Humidification
Surgical site infection
url https://doi.org/10.1038/s41598-025-14082-0
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