The effect of viable omentum on early bile leakage and healing of liver lacerations.
In order to determine if omental tissue accelerates the healing of liver lacerations, simulated bile leakage and collagen biosynthesis were studied in 53 rabbits. After creating a standardized complex liver laceration, hemostasis was obtained by vessel ligation and electrocoagulation. The wound was either left open (OP) or viable omentum sutured to its base (OM). Simulated bile leakage was noted in all of eight animals (four OM, four OP) studied on day of injury. None of 18 OM and two of 17 OP animals demonstrated extravasation of dye from the wound on the second and third postinjury day (N.S.). The ratio of mRNA for alpha 1(I) procollagen/actin, used as an indicator of wound healing, was 56.3 +/- 7.8 for OM and 50.6 +/- 12.1 for OP at the wound edge, and 63.5 +/- 18.6 and 69.2 +/- 7.5, respectively, for RNA isolated from the scar (N.S.). For alpha 1(III) procollagen mRNA, the ratio was 23.9 +/- 3.5 for OM and 22.4 +/- 8.3 for OP at the wound edge, and 32.4 +/- 6.5 and 31.8 +/- 7.9, respectively, for RNA isolated from the scar (N.S.). There was no difference in the scar hydroxyproline content between the two repair methods. In this model of hepatic injury and repair, bile leakage was minimal by the second postinjury day with both repair methods. Placing the omentum in liver lacerations did not contribute to accelerated wound healing as measured by simulated bile leakage and collagen biosynthesis.
Trooskin
S Z
SZ
Department of Surgery, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick 08903.
Pierce
R A
RA
Deak
S B
SB
Flancbaum
L
L
MacKenzie
J W
JW
Greco
R S
RS
Boyd
C D
CD
D000818:Animals; D001646:Bile; D004247:DNA / Q000378:metabolism; D006909:Hydroxyproline / Q000378:metabolism; D008099:Liver / Q000293:injuries* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D009852:Omentum / Q000637:transplantation*; D011347:Procollagen / Q000378:metabolism; D012333:RNA, Messenger / Q000378:metabolism; D011817:Rabbits; D014945:Wound Healing
D011347:Procollagen; D012333:RNA, Messenger; D004247:DNA; D006909:Hydroxyproline