Volkov O.E., Zavada N.V., Ladutko I.M.
Experimental substantiation of applying the method of stitching up small intestine ruptures with everted mechanical suture using amniotic membrane
Belarusian Medical Academy of Post-Graduate Education, Minsk, Republic of Belarus
Vestnik VGMU. 2017;16(3):38-45.
Objectives. In an experiment on rabbits to prove the effectiveness of stitching up the small intestine rupture by the method of everted mechanical suture covered with an amniotic membrane.
Material and methods. Rabbit intestinal rupture model by hydrodynamic strike was used to perform this study. After small intestine damage modelling all animals were divided into 3 groups: P0 – ruptured intestine suturing was performed immediately, P3 – damaged intestine was placed in the abdominal cavity, which was closed with single stiches, and 3 hours later relaparotomy and intestine suturing were performed, P24 – damaged intestine was placed in the abdominal cavity, which was closed with single stiches, and 24 hours later relaparotomy and intestine suturing were performed.
In each of the groups, suturing was performed in one of three ways: subgroup 1 (HS) – small intestine damage was sutured with single continuous hand-wound stiches 6-0 (Schmiden’s stich), which was covered by single-row Lembert stitches, subgroup 2 (ST) – with mechanical suture in the transverse direction by the linear stapler device, then it was covered by single-row serous Lembert stitches, subgroup 3 (ST + AM) – an everted mechanical seam was applied in the transverse direction, which was covered with a patch of cryopreserved amniotic membrane. The experimental animals were crucified after intestinai rupture suturing on the 7th, the 14th and the 30th days.
Results. Postoperative mortality, operation duration, leakage rate, mechanical stitch strength and severity of the adhesive process in the abdominal cavity were evaluated.
Conclusions. The proposed suture showed a higher efficacy than the standard intestine suturing technique.
Key words: small intestine damage, amniotic membrane, everted mechanical suture, leakage rate, adhesive process.
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Information about authors:
Volkov O.E. – postgraduate of the Chair of Emergency Surgery, Belarusian Medical Academy of Post-Graduate Education;
Zavada N.V. – Doctor of Medical Sciences, professor of the Chair of Emergency Surgery, Belarusian Medical Academy of Post-Graduate Education;
Ladutko I.M. – Candidate of Medical Sciences, associate professor of the Chair of Emergency Surgery, Belarusian Medical Academy of Post-Graduate Education.