Neutrophil-Dependent Decrease in Early Wound Margin Strength

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.

Role of CD18-Dependent Neutrophil Recruitment in Skin and Intestinal Wound Healing

“…This suggests that neutrophil infiltration does not negatively influence the healing process in anastomosis in the rat colon. These findings are in contrast to a previous study reporting that breaking strength on day 3 was improved by treatment with anti-neutrophil serum [9]. The reason for these discrepant findings may be related to the different tissues examined, i.e.…”

“…The reason for these discrepant findings may be related to the different tissues examined, i.e. Jonsson and Hög-ström [9] used the ileum whereas we used the colon. Because the metabolism in the ileum is higher than in the colon, the small intestine may be more sensitive to surgical trauma and inflammation.…”

“…colonic wound healing is unaffected by administration of corticosteroids at doses which impair dermal wound healing [6]. Nonetheless, it has been suggested that surgically induced inflammation and leukocyte recruitment may impair wound healing in the skin [7,8] and gastrointestinal tract [9,10], possibly as a result of neutrophils releasing toxic products such as oxygen free radicals, proteases and vasoactive substances [11][12][13][14][15]. However, the literature is complex and contradictory with regard to the effectiveness of inhibiting inflammatory cell recruitment in wound healing.…”

“…However, the literature is complex and contradictory with regard to the effectiveness of inhibiting inflammatory cell recruitment in wound healing. For example, some report that neutrophil infiltration may be detrimental [9], whereas others indicate that neutrophils promote [16,17] the wound-healing process. Although the leukocyte response in inflammatory reactions is rather stereotypical, it has been demonstrated that the mechanisms of tissue regeneration in the skin and intestinal tract are partly different [4].…”

Effect of thalidomide on the healing of colonic anastomosis, in rats

“…43 It has been already demonstrated that elevated submucosal collagen degradation by metalloproteinases can predispose to the dehiscence of anastomosis 44 and that the inhibition of metalloproteinases can have a promising action in healing. 45,46 Thus, a firmer scar is expected to occur in a tissue where the action of metalloproteinase inhibitors prevails, and a looser and more tenuous scar is expected to occur in situations of imbalance towards the presence of metalloproteinases (greater collagen degradation).…”