Effect of early postoperative nutritional support on skin wound and colon anastomosis healing.
Improved healing occurs in nutritionally depleted rats given early postoperative compared with delayed feeding. The present study was designed to test the hypothesis that delay in postoperative feeding of rats normally nourished at the time of operation would also be detrimental to wound healing. Fully nourished rats weighing 288 to 342 g were divided into three groups (10 rats per group). All rats had central vein catheters inserted, celiotomy with division and reanastomsis of the colon and dorsal skin incisions, under ip pentobarbital anesthesia. With no oral intake allowed postoperatively, group 1 rats were maintained in iv 5% Dextrose electrolytes and vitamins (5% DSV); group 2 was given the 5% D/SV until the third postoperative day when they were placed on TPN (4.5% amino acids 15% Dextrose, 10% Intralipids); and group 3 was given TPN from the first postoperative day. Rats were sacrificed 6 days postoperatively and final weight, skin wound breaking strength (WBS) and colon anastomosis bursting pressure (CBP) were measured. Findings were % weight change -27.8 +/- 1.5 for Group 1, -12.6 +/- 1.0 for Group 2, and -6.9 +/- 8 for group 3 (p less than 0.0001). Wound measurements for STS on fresh specimens were 88.6 +/- 10.0 g for group 1, 89.1 +/- 8.4 g for group 2, and 87.1 +/- 11.1 g for group 3. WBS for formalin-fixed specimens were 313.5 +/- 29.7 g for group 1, 323.4 +/- 38.4 g for group 2, and 382 +/- 25.2 g for group 3 (NS).(ABSTRACT TRUNCATED AT 250 WORDS)
Delany
H M
HM
Combined Department of Surgery, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York.
Demetriou
A A
AA
Teh
E
E
Levenson
S M
SM
D000714:Anastomosis, Surgical; D000818:Animals; D003106:Colon / Q000601:surgery*; D062109:Dermatologic Surgical Procedures; D008297:Male; D010289:Parenteral Nutrition, Total; D011182:Postoperative Care / Q000379:methods*; D011379:Prognosis; D051381:Rats; D011919:Rats, Inbred Strains; D013997:Time Factors; D014945:Wound Healing