Effect Of Ischemia-Reperfusion On Healing In Intestinal Anastomosis

Abstract

The effect of reperfusion injury on the healing of intestinal anastomotic wound directly subjected to ischemia-reperfusion stress was investigated in dogs. Three groups of dogs were utilized for the study. In group A (Control) cranial mesenteric artery and collateral blood supply were isolated but not occluded. In groups B and C, the ccranial mesenteric artery was isolated and occluded immediately distal to the aorta with collateral interruption using an atraumatic arterial clip either for fifteen minutes (Group B) or for forty-five minutes (Group C). This was followed by ileal resection and anastomosis after the return of normal perfusion. Within each group, the dogs were anaesthesized on third and seventh post-operative days in order to observe the healing f the intestinal anastomosis. Abdominal wound healing, intra-abdominal adhesions and anastomotic complications were observed postoperatively at day 3 and 7 in group C. Significantly high numbers of both partial and complete anastomotic dehiscence and adhesions occurred in group C compared to groups A and B. This was commensurate with the intensity of the ischemic insult. This should be taken into consideration when evaluating patients with intgestinal conditions involving compromise of blood supply and when resuscitating severely injured patients of shock or hypovolemia.

Keywords: Gross lesions, ischemia-reperfusion injury, intestinal anastomoses, wound healing.

Tropical Veterinarian Vol. 24 (3) 2006: pp. 62-69