Alcohol acute intoxication before sepsis impairs the wound healing of intestinal anastomosis: rat model of the abdominal trauma patient

Abstract

IntroductionMost trauma patients are drunk at the time of injury. Up to 2% of traumatized patients develop sepsis, which considerably increases their mortality. Inadequate wound healing of the colonic repair can lead to postoperative complications such as leakage and sepsis.ObjectiveTo assess the effects of acute alcohol intoxication on colonic anastomosis wound healing in septic rats.MethodsThirty six Wistar rats were allocated into two groups: S (induction of sepsis) and AS (alcohol intake before sepsis induction). A colonic anastomosis was performed in all groups. After 1, 3 or 7 days the animals were killed. Weight variations, mortality rate, histopathology and tensile breaking strength of the colonic anastomosis were evaluated.ResultsThere was an overall mortality of 4 animals (11.1%), three in the group AS (16.6%) and one in the S group (5.5%). Weight loss occurred in all groups. The colon anastomosis of the AS group didn’t gain strength from the first to the seventh postoperative day. On the histopathological analysis there were no differences in the deposition of collagen or fibroblasts between the groups AS and S.ConclusionAlcohol intake increased the mortality rate three times in septic animals. Acute alcohol intoxication delays the acquisition of tensile strength of colonic anastomosis in septic rats. Therefore, acute alcohol intoxication before sepsis leads to worse prognosis in animal models of the abdominal trauma patients.

Does acute alcohol intoxication interfere with colonic anastomosis wound healing?: a rat model of nondestructive colon trauma

“…Nevertheless, a previous study by our research group found that colonic anastomosis wound healing is impaired in rats with peritoneal sepsis and acute alcohol intake with the same alcohol exposure pattern used in the current study 12 . This suggests that diversion may be required if the intoxicated patient has fecal contamination and sepsis, as occurs in destructive colon trauma, for instance 12 .…”

“…This suggests that diversion may be required if the intoxicated patient has fecal contamination and sepsis, as occurs in destructive colon trauma, for instance 12 . In our previous study, which included two groups (sepsis + alcohol and sepsis alone), the sepsis group exposed to alcohol exhibited poorer wound healing.…”

“…We hypothesized that acute alcohol exposure shortly before surgery would be a risk factor for impaired wound healing of the colonic anastomosis, based on results from other experimental studies [9][10][11][12] . However, in those studies, alcohol exposure followed different patterns.…”

“…The effects of alcohol abuse on patient prognosis and on experimental wound healing are highly controversial, because they depend on the type of exposure and on the presence of associated factors such as sepsis 12 .…”

The world of trauma working together

“…This work was awarded the best paper at the 2011 Eastern Association for the Surgery of Trauma annual meeting. Another interesting manuscript reports on the role of alcohol and sepsis on the tensile strength of bowel anastomosis [ 7 ]. On novel diagnostic methods and therapies, Dr Sankarankutty reviewed the literature on the possible role of thromboelastometry [ 8 ] while another study reports on the lack of utility for recombinant factor VIIa in trauma [ 9 ].…”