Comparative study of hand sewn single layer anastomosis of dog's bowel

Abstract

-Background -Two-layer intestinal anastomosis increases the inflammatory response while single-layer anastomosis results in a better wound healing. However the four main kinds of stitches which may be chosen in performing single layer intestinal sutures never before had been comparatively studied. Aim -To compare the four more commonly used types of single layer surgical anastomosis sutures of the digestive tract. Methods -Six mongrel dogs were operated, each one receiving two anastomosis: one at 30 cm from de Treitz angle -sero-submucosal technique, and the other at 60 cm -total technique. This placement was alternatively inverted. The four more commonly used types of single layer surgical anastomosis sutures of the digestive tract, namely: sero-submucosal stitches tied in the lumen, over the submucosa; sero-submucosal stitches tied in the exterior of the organ, over the serosa; total stitches tied in the lumen, over the mucosa; and total sutures tied in the exterior, over the serosa (Gambee's stitches) were tested. After euthanasia (7th post-operative day) macro and microscopic features were evaluated. Friedman's test was applied for morphometry and for evaluation of the peritoneal adhesions. Results -Statistical significance was demonstrated through major residual acute inflammation and proliferation in total sutures and more profuse adhesions with the sero-submucosal stitches tied in the lumen. The sero-submucosal stitches tied in the exterior over the serosa, had excellent realignment and regeneration of the layers. Conclusion -The sero-submucosal stitches tied in the exterior, over the serosa, were the best ones.