BACKGROUND: Considering the potential deleterious effects of transfusion, the effect of severe, acute anemia on small intestine (SI) and large intestine (LI) anastomoses was evaluated. METHODS: Thirty-six rabbits underwent segmental resection of the midileum and distal colon. Half underwent preanastomotic removal of 30% of their blood volume with crystalloid resuscitation. At 1 or 2 weeks, the anastomotic bursting pressure (ABP) and histologic grade of white blood cell influx, blood vessel ingrowth, fibroblast proliferation, and collagen deposition were assessed. RESULTS: SI ABP was decreased in anemic rabbits at 2 weeks (190 +/- 6 mm Hg vs. 257 +/- 17 mm Hg). LI ABP was decreased at 1 week in anemic rabbits. In the test rabbits, histologic parameters were altered in both the SI and LI with decreased white blood cell infiltration, attenuated blood vessel ingrowth, and decreased collagen content at both 1 and 2 weeks. Decreased SI fibroblast proliferation was present at 1 week. CONCLUSION: Acute anemia in the rabbit undergoing intestinal resection decreases the SI ABP at 2 weeks and alters histologic parameters of wound healing in both the SI and LI.
BACKGROUND: Considering the potential deleterious effects of transfusion, the effect of severe, acute anemia on small intestine (SI) and large intestine (LI) anastomoses was evaluated. METHODS: Thirty-six rabbits underwent segmental resection of the midileum and distal colon. Half underwent preanastomotic removal of 30% of their blood volume with crystalloid resuscitation. At 1 or 2 weeks, the anastomotic bursting pressure (ABP) and histologic grade of white blood cell influx, blood vessel ingrowth, fibroblast proliferation, and collagen deposition were assessed. RESULTS: SI ABP was decreased in anemic rabbits at 2 weeks (190 +/- 6 mm Hg vs. 257 +/- 17 mm Hg). LI ABP was decreased at 1 week in anemic rabbits. In the test rabbits, histologic parameters were altered in both the SI and LI with decreased white blood cell infiltration, attenuated blood vessel ingrowth, and decreased collagen content at both 1 and 2 weeks. Decreased SI fibroblast proliferation was present at 1 week. CONCLUSION: Acute anemia in the rabbit undergoing intestinal resection decreases the SI ABP at 2 weeks and alters histologic parameters of wound healing in both the SI and LI.
Authors: Toufic R Jildeh; Kelechi R Okoroha; Nathan E Marshall; Abraham Abdul-Hak; Ferras Zeni; Vasilios Moutzouros Journal: Orthop J Sports Med Date: 2018-05-25