Diathermy-Induced Inflammation Does Not Affect Suture Holding Capacity of Intestinal Anastomoses

Abstract

We compared the suture holding capacity of rat intestinal anastomoses after division of the bowel with scissors or diathermy. Two sets of experiments differing in suture technique were done. In one set the amount and solubility of anastomotic collagen were measured, and neutrophil accumulation quantified with a myeloperoxidase (MPO) assay. MPO activity 24 h after surgery was 60% higher (p < 0.05) after division with diathermy than after division with scissors. Suture holding capacity (breaking strength) decreased by approximately 70% (p < 0.001) in both groups when sutures were inserted near the bowel edges, while no decrease was noted when sutures were inserted at a farther distance, regardless of the mode of bowel division. After 7 days MPO levels approached baseline values in both groups and the bowel always ruptured outside the anastomosis. Collagen content was not adversely affected by diathermy. Although the reduction in early anastomotic strength may be mediated by local neutrophil activity, suture holding capacity was not influenced by the increased neutrophil accumulation elicited by diathermy.

Effect of Interrupted and Continuous Suturing on Intestinal Wound Margin Strength in Rats

“…1-3). This is in congruence with results of a previous study which found that the degree of neutrophil accumulation was not decisive for anastomotic suture holding capacity [4], Most proteinase inhibitors are blood borne and their concentration in tissue may there fore be susceptible to changes in perfusion. As the inhibitors are relatively large molecules, extravascular diffusion in tightly compressed tissue might be restricted.…”

Influence of small intestinal serosal defect closure on leakage rate and adhesion formation: a pilot study using rabbit models

“…This is in accordance to several studies investigating intestinal wound healing which could objectify that the regularly used suture material leads to an impairment of wound healing due to ischemia [31][32][33]. An explanation for the proven negative effect on wound healing on a more molecular level could be that tight sutures may promote proteolytic tissue degradation by reducing the local availability of circulating proteinase inhibitors [32][33][34]. 5 In the non-closure group, the serosal defects were completely healed and showed a shiny reflection of the neoperitoneum.…”

Η Χρήση Σπόγγου Επικαλυμμένου Με Ανθρώπινο Ινωδογόνο Και Ανθρώπινη Θρομβίνη Στην Επίτευξη Της Στεγανότητας Των Αναστομώσεων Του Πεπτικού Σωλήνα

“…Η διαθερµία εν τούτοις έχει το πλεονέκτηµα ότι προσφέρει επιπλέον αιµόσταση, ενώ οι µικρές τοπικές νεκρώσεις που προκαλούνται στην περιοχή της αναστόµωσης απορροφούνται χωρίς αρνητικές συνέπειες. 183,184 Τα τελευταία χρόνια αναφέρεται η χρήση διαφόρων προϊόντων µε στόχο την ισχυροποίηση των αναστοµώσεων. Η χρήση ιστικής κόλλας ινικής έχει αποφέρει ενθαρρυντικά αποτελέσµατα σε διάφορες µελέτες.…”