Loss of colonic structural collagen impairs healing during intra-abdominal sepsis.
OBJECTIVE
To investigate colon anastomotic healing in an experimental model of sepsis.


METHODS
Prospective, randomized, experimental trial.


METHODS
Experimental surgical laboratory of a large community hospital.


METHODS
Twenty-eight male Sprague-Dawley rats weighing 310 to 380 g.


METHODS
On day 0, the rats underwent either sham laparotomy or cecal ligation and puncture. The next day, the rats underwent left colon resection and single-layer inverted anastomosis. Colon-bursting pressure was determined 5 days after surgery at which time the anastomosis and a segment of colon 3 cm proximal to the anastomosis were excised.


METHODS
Colon-bursting pressure, colonic hydroxyproline concentration (index of collagen content), and total protein concentration measured as alpha-amino nitrogen.


RESULTS
Sepsis resulted in decreased anastomotic bursting pressure and collagen concentration in all colon segments that were analyzed in the animals that underwent cecal ligation and puncture compared with control animals.


CONCLUSIONS
Sepsis impairs healing of the colon, reflected by decreased bursting pressure and collagen concentration. The decrease in bowel wall structural collagen may affect the ability of the gut to hold sutures and thus may lead to more anastomotic failure.
Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, Md.
G M
GM
Ahrendt
K
K
Gardner
A
A
Barbul
D000714:Anastomosis, Surgical; D000818:Animals; D003094:Collagen / Q000378:metabolism / Q000502:physiology*; D003106:Colon / Q000378:metabolism / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D011312:Pressure; D011446:Prospective Studies; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D018805:Sepsis / Q000503:physiopathology*; D013529:Surgical Wound Dehiscence / Q000503:physiopathology; D014945:Wound Healing / Q000502:physiology*
D003094:Collagen