Skip to main content
Annals of Surgery logoLink to Annals of Surgery
. 1985 Mar;201(3):360–364. doi: 10.1097/00000658-198503000-00019

Accelerated wound healing with stapled enteric suture lines. An experimental study comparing traditional sewing techniques and a stapling device.

G H Ballantyne, J B Burke, G Rogers, E G Lampert, J Boccia
PMCID: PMC1250681  PMID: 3883920

Abstract

The healing of 3-cm longitudinal colotomies closed with either Czerny-Lembert suture lines (CLSL) or TA-30 staple lines (SSL) were studied in 28 mongrel dogs using bursting strength (BS) measurements. Dogs from each group were sacrificed on postoperative days (POD) 1 through 7. Mean BS for the SSL in all 14 dogs was 165 mmHg +/- 64 and for CLSL 80 mmHg +/- 49 (DF = 13; t = 5.5672; p less than 0.00005 for matched pairs). For POD 2 through 5, BS of the SSL was 154 mmHg +/- 42, three times greater than the BS of the CSLS, which was 54 mmHg +/- 33 (DF = 7; t = 5.6289; p less than 0.0004 for matched pairs). BS of the SSL increased linearly from the first day of surgery: BS (mmHg) = 26 (POD) + 61 (n = 14; r = 0.838; p less than 0.01). BS of the CLSL followed the traditional pattern of wound healing dropping to a nadir after 3 days and then increasing linearly: BS (mmHg) = 32 (POD) - 72 (n = 10; r = 0.834; p less than 0.01). Microscopic examination revealed a greater inflammatory response to the CSLS than the SSL. Differences were most marked from 2 to 4 days following operation. Thus, the SSL healed more rapidly than the CLSL as measured by BS. The SSL healed with a negligible Lag Period of wound healing entering directly into the Period of Fibroplasia.

Full text

PDF
362

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. AMOSOV N. M., BEREZOVSKY K. K. Pulmonary resection with mechanical suture. J Thorac Cardiovasc Surg. 1961 Mar;41:325–335. [PubMed] [Google Scholar]
  2. Ballantyne G. H. Intestinal suturing. Review of the experimental foundations for traditional doctrines. Dis Colon Rectum. 1983 Dec;26(12):836–843. doi: 10.1007/BF02554767. [DOI] [PubMed] [Google Scholar]
  3. Ballantyne G. H. The experimental basis of intestinal suturing. Effect of surgical technique, inflammation, and infection on enteric wound healing. Dis Colon Rectum. 1984 Jan;27(1):61–71. doi: 10.1007/BF02554084. [DOI] [PubMed] [Google Scholar]
  4. Beart R. W., Jr, Kelly K. A. Randomized prospective evaluation of the EEA stapler for colorectal anastomoses. Am J Surg. 1981 Jan;141(1):143–147. doi: 10.1016/0002-9610(81)90027-1. [DOI] [PubMed] [Google Scholar]
  5. Bronwell A. W., Rutledge R., Dalton M. L., Jr Single-layer open gastrointestinal anastomosis. Ann Surg. 1967 Jun;165(6):925–932. doi: 10.1097/00000658-196706000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cronin K., Jackson D. S., Dunphy J. E. Changing bursting strength and collagen content of the healing colon. Surg Gynecol Obstet. 1968 Apr;126(4):747–753. [PubMed] [Google Scholar]
  7. Dunn D. H., Robbins P., Decanini C., Goldberg S., Delaney J. P. A comparison of stapled and hand-sewn colonic anastomoses. Dis Colon Rectum. 1978 Nov-Dec;21(8):636–639. doi: 10.1007/BF02586416. [DOI] [PubMed] [Google Scholar]
  8. Greenstein A., Rogers P., Moss G. Doubled fourth-day colorectal anastomotic strength with complete retention of intestinal mature wound collagen and accelerated deposition following immediate full enteral nutrition. Surg Forum. 1978;29:78–81. [PubMed] [Google Scholar]
  9. Gritsman J. J. Mechanical suture by Soviet apparatus in gastric resection: use in 4,000 operations. Surgery. 1966 May;59(5):663–669. [PubMed] [Google Scholar]
  10. HERRMANN J. B., WOODWARD S. C., PULASKI E. J. HEALING OF COLONIC ANASTOMOSES IN THE RAT. Surg Gynecol Obstet. 1964 Aug;119:269–275. [PubMed] [Google Scholar]
  11. Hawley P. R., Faulk W. P., Hunt T. K., Dunphy J. E. Collagenase activity in the gastro-intestinal tract. Br J Surg. 1970 Dec;57(12):896–900. doi: 10.1002/bjs.1800571206. [DOI] [PubMed] [Google Scholar]
  12. Lord M. G., Broughton A. C., Williams H. T. A morphologic study on the effect of suturing the submucosa of the large intestine. Surg Gynecol Obstet. 1978 Feb;146(2):211–216. [PubMed] [Google Scholar]
  13. Polglase A. L., Hughes E. S., McDermott F. T., Pihl E., Burke F. R. A comparison of end-to-end staple and suture colorectal anastomosis in the dog. Surg Gynecol Obstet. 1981 Jun;152(6):792–796. [PubMed] [Google Scholar]
  14. Ravitch M. M., Rivarola A., Van Grov J. Rapid creation of gastric pouches with the use of an automatic stapling instrument. J Surg Res. 1966 Feb;6(2):64–65. doi: 10.1016/s0022-4804(66)80072-0. [DOI] [PubMed] [Google Scholar]
  15. Scott R. N., Faraci R. P., Goodman D. G., Militano T. C., Geelhoed G. W., Chretien P. B. The role of inflammation in bronchial stump healing. Ann Surg. 1975 Apr;181(4):381–385. doi: 10.1097/00000658-197504000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES