No abstract

We evaluated the effect of neutropenia or administration of a serine proteinase inhibitor on the early suture-holding capacity of intestinal anastomoses in rats. One group of rats was treated with antineutrophil serum, and another group received the soybean trypsin inhibitor. Controls received inactivated serum or saline. Anastomotic suture-holding capacity (breaking strength), myeloperoxidase activity, and collagen were measured 0 and 72 hours after surgery. Suture-holding capacity decreased by 70% in controls and 35% in soybean trypsin inhibitor-treated rats, but remained on level with immediate postoperative strength in neutropenic rats, where low myeloperoxidase levels reflected effective wound margin neutropenia. Collagen content and solubility were similar in all groups. These findings indicate that reduction in early wound margin strength is neutrophil dependent, and that neutrophil serine proteinases are important mediators in that process.

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We compared the suture holding capacity of rat intestinal anastomoses after division of the bowel with scissors or diathermy. Two sets of experiments differing in suture technique were done. In one set the amount and solubility of anastomotic collagen were measured, and neutrophil accumulation quantified with a myeloperoxidase (MPO) assay. MPO activity 24 h after surgery was 60% higher (p < 0.05) after division with diathermy than after division with scissors. Suture holding capacity (breaking strength) decreased by approximately 70% (p < 0.001) in both groups when sutures were inserted near the bowel edges, while no decrease was noted when sutures were inserted at a farther distance, regardless of the mode of bowel division. After 7 days MPO levels approached baseline values in both groups and the bowel always ruptured outside the anastomosis. Collagen content was not adversely affected by diathermy. Although the reduction in early anastomotic strength may be mediated by local neutrophil activity, suture holding capacity was not influenced by the increased neutrophil accumulation elicited by diathermy.

No abstract