title: Mesh reinforcement increases bursting strength of intestinal anastomoses in steroid-treated rabbits.
abstract: We tested the hypothesis that reinforcement of small bowel anastomoses with polyglycolic acid mesh (PGAM) would increase bursting strength in steroid-treated subjects. Twenty-two New Zealand white rabbits weighing 3-4 kg received methylprednisolone 0.2 mg/kg/day IM for 7-13 days preoperatively and until killed 4-5 days postoperatively. Steroid effect was confirmed by a 58.3 per cent decrease in absolute lymphocyte count and a histologic reduction in anastomotic fibroblast proliferation and collagen deposition. Two small bowel anastomoses were performed in each animal using standard two-layer suture technique. One of the two anastomoses, randomly assigned, was circumferentially reinforced with PGAM such that each animal served as its own control. Anastomotic bursting pressures, determined on postoperative Day 4-5, were significantly higher in mesh-reinforced anastomoses (P = 0.003). Histologic examination of the reinforced anastomoses revealed a well-developed layer of fibroblasts and collagen between the PGAM and bowel wall serosa. These results demonstrate that polyglycolic acid mesh reinforcement significantly increases the bursting strength of small bowel anastomoses in steroid-treated rabbits.
authors.affiliation: Department of Surgery, University of Southern California School of Medicine, Los Angeles 90033.
authors.forename: W
authors.initials: W
authors.lastname: Raboff
authors.forename: M B
authors.initials: MB
authors.lastname: Calobrace
authors.forename: G
authors.initials: G
authors.lastname: Anthony
authors.forename: D
authors.initials: D
authors.lastname: Garner
authors.forename: D
authors.initials: D
authors.lastname: Greenwald
authors.forename: A
authors.initials: A
authors.lastname: Brant
authors.forename: B
authors.initials: B
authors.lastname: Hopkins
authors.forename: V
authors.initials: V
authors.lastname: Soonthon
authors.forename: T
authors.initials: T
authors.lastname: Noonan
authors.forename: W
authors.initials: W
authors.lastname: Hofstetter
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation* / Q000379:methods; D000818:Animals; D003094:Collagen / Q000187:drug effects; D004195:Disease Models, Animal; D005347:Fibroblasts / Q000187:drug effects; D007421:Intestine, Small / Q000187:drug effects / Q000473:pathology / Q000601:surgery*; D018655:Lymphocyte Count / Q000187:drug effects; D008214:Lymphocytes / Q000187:drug effects; D008297:Male; D008422:Materials Testing; D008775:Methylprednisolone / Q000009:adverse effects*; D011100:Polyglycolic Acid; D011817:Rabbits; D011897:Random Allocation; D013526:Surgical Mesh; D013536:Suture Techniques; D013718:Tensile Strength; D014945:Wound Healing / Q000187:drug effects
chemical_list: D011100:Polyglycolic Acid; D003094:Collagen; D008775:Methylprednisolone