DOI: https://doi.org/10.22263/2312-4156.2017.3.29
Zavada N.V., Volkov O.E., Ryabtseva S.N., Shved I.A.
Small intestinal rupture stitching up with everted mechanical suture covered with amniotic membrane as a method for adhesions prevention in the abdominal cavity (the experimental study)
Belarusian Medical Academy of Post-Graduate Education, Minsk, Republic of Belarus
Vestnik VGMU. 2017;16(3):29-37.
Abstract.
Objectives. In an experiment to evaluate adhesions prevention effect of everted mechanical suture covered with an amniotic membrane for intestinal rupture.
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: group 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 intestinal rupture suturing on the 7th, the 14th and the 30th days.
Results. The following morphological changes were assessed: inflammatory reaction severity, connective tissue scar formation, fibrous adhesions tendency. When we used an everted mechanical seam covered with a cryopreserved amniotic membrane patch, we found out the statistically significantly lower fibrous scar thickness in the bowel wall defect area and a less pronounced fibrous adhesions formation outside the damage zones. It was also found out that on using manual suture fibrosis was more pronounced with the largest scar formation in comparison with the other groups.
Conclusions. The proposed method enables the reduction of the abdominal adhesions formation intensity.
Key words: small intestine damage, amniotic membrane, everted mechanical suture, fibrosis.
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Information about authors:
Zavada N.V. – Doctor of Medical Sciences, professor of the Chair of Emergency Surgery, Belarusian Medical Academy of Post-Graduate Education;
Volkov O.E. – postgraduate of the Chair of Emergency Surgery, Belarusian Medical Academy of Post --Graduate Education;
Ryabtseva S.N. – Candidate of Medical Sciences, research officer of the pathomorphologic team of the Scientific-Research Laboratory, Belarusian Medical Academy of Post-Graduate Education;
Shved I.A. – Doctor of Medical Sciences, professor, principal officer of the pathomorphologic team of the Scientific-Research Laboratory Belarusian Medical Academy of Post-Graduate Education.
Correspondence address: Republic of Belarus, 220013, Minsk, 3-3 P. Brovki str., Belarusian Medical Academy of Post-Graduate Education, Chair of Emergency Surgery. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Oleg E. Volkov.
