Angiography as an index of healing in experimental laparotomy wounds and colonic anastomoses.

The vascular anatomy of healing wounds in rat abdominal wall and obstructed large bowel was examined by sequential angiography, with particular reference to the possibility of tissue necrosis following mass closure of the abdominal wall and of dehiscence after primary anastomosis in obstructed colon. In the abdominal wall, gross distortion of the vascular anatomy one to two weeks after mass closure was accompanied by a central wound zone which had an appearance suggestive of necrosis. By the fourth week after closure vascular anatomy was restored and "necrosis" completely resolved. In left colon that had been acutely obstructed for 72 h an increased risk of anastomotic failure was accompanied by delays in the appearance of new vessels and their growth across the anastomosis, as detected by colonic angiography. Mass closure should not be discarded because of the hypothetical risk of tissue necrosis. Primary anastomosis in acutely obstructed colon is contra-indicated because of risk of delayed healing.