title: The effect of relaparotomy timing on wound healing in an animal model.
abstract: BACKGROUND
  The effect of the timing of the second laparotomy on wound healing is not clear. In an experimental study in rats, we aimed to investigate the effect of timing on wound healing after reoperations on the same surgical site.
  
  
  METHODS
  Forty-eight rats were divided into four groups. The control group (GC) didn't have another laparotomy whereas the relaparotomies on the same surgical site were performed either on the 3rd, 15th or the 30th postoperative days in the three study groups (G3, G15, G30 respectively). The midline tension pressure, collagen types I, III and, histological analysis were performed from the specimens in order to assess the wound healing and strength.
  
  
  RESULTS
  The tensile strength was the highest in GC and decreased gradually in G3, G15 and G30, the difference between the groups did not reach statistical significance. Higher collagen levels, increased fibrosis, and large defects were observed in relaparotomy groups than CG. The musculoaponeurotic gap was shortest in GC when compared to other three relaparotomy groups (P < 0.001) and, it was the longest in G30 (P = 0.004 between G3 and G30).
  
  
  CONCLUSIONS
  Although non-statistically significant the gradual decrease in the tensile strength and the statistically significant increase in the musculoaponeurotic gap with time point out the importance of the timing of relaparotomy in the healing process. Early relaparotomies do not disrupt the healing process as much as relaparotomy performed later.
authors.affiliation: Department of General Surgery, Diskapi Teaching and Research Hospital, Ankara, 06110, Turkey. Electronic address: melihakinci@yahoo.com.
authors.forename: Melih
authors.initials: M
authors.lastname: Akinci
authors.affiliation: Department of General Surgery, Diskapi Teaching and Research Hospital, Ankara, 06110, Turkey.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Ergul
authors.affiliation: Department of Gastroenterology, Gülhane Military Medical Academy, Ankara, 06010, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Kantarcioglu
authors.affiliation: Department of Medical Biochemistry, Gülhane Military Medical Academy, Ankara, 06010, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Tapan
authors.affiliation: Department of Physiology, Gülhane Military Medical Academy, Ankara, 06010, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozler
authors.affiliation: Department of Pathology, Gülhane Military Medical Academy, Ankara, 06010, Turkey.
authors.forename: Armagan
authors.initials: A
authors.lastname: Gunal
authors.affiliation: Department of General Surgery, Diskapi Teaching and Research Hospital, Ankara, 06110, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Kulacoglu
authors.affiliation: Department of Laboratory Animal Health Center for Research & Development, Gülhane Military Medical Academy, Ankara, 06010, Turkey.
authors.forename: Tayfun
authors.initials: T
authors.lastname: Ide
authors.affiliation: Department of Pharmaceutical Toxicology, Gülhane Military Medical Academy, Ankara, 06010, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Sayal
authors.affiliation: Department of Emergency Medicine, Gülhane Military Medical Academy, Ankara, 06010, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Eryilmaz
authors.affiliation: Department of General Surgery, Gülhane Military Medical Academy, Ankara, 06010, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Kozak
mesh_terms: D000818:Animals; D003094:Collagen / Q000032:analysis; D004195:Disease Models, Animal; D007813:Laparotomy; D051381:Rats; D012086:Reoperation; D013718:Tensile Strength / Q000502:physiology*; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology*
chemical_list: D003094:Collagen
keywords: Incisional hernia; Musculoaponeurotic gap; Relaparotomy; Tensile strength; Wound healing