Agalar F, Hamaloglu E, Daphan C, Tarim A, Onur R, Renda N, Sayek I
Department of General Surgery, Suleyman Demirel University Faculty of Medicine, Isparta, Turkey.
Aust N Z J Surg. 2000 Oct;70(10):739-42. doi: 10.1046/j.1440-1622.2000.01890.x.
The aim of the present study was to evaluate the effects of laparotomy and CO2 insufflation on wound healing in a murine incisional wound healing model.
Seventy-two male Swiss Albino mice were randomly allocated into three groups of control, laparotomy and CO2 insufflation. A transverse skin incision of 15 mm was made in the dorsum of each mouse, and four interrupted mattress sutures with 4.0 polypropylene thread were laid for wound closure. A median laparotomy was performed in the laparotomy group. CO2 insufflation was performed with an intra-abdominal pressure of 9 mmHg. The retained gas was evacuated from the abdominal cavity at the end of a 60-min period. Mice were killed on the 3rd, 7th and 15th postoperative days. The wound tensile strength and 5-hydroxyproline concentration in the wound tissue were measured.
Tensile strength of the incised skin increased as the post-incision period progressed. There was no significant difference between the tensile strengths of the incised skin of control, laparotomy and CO2 insufflation groups throughout the observation period. The skin 5-hydroxyproline concentrations of all groups were not significantly different at the 3rd postoperative day. But laparotomy and CO2 insufflation groups had lower 5-hydroxyproline concentrations at the 7th and 15th postoperative days, when compared to controls (P < 0.02 for 7th and 15th days).
CO2 insufflation and laparotomy reduce the 5-hydroxyproline concentration of the wound, suggesting a diminished wound healing capacity.
本研究的目的是在小鼠切口愈合模型中评估剖腹术和二氧化碳气腹对伤口愈合的影响。
72只雄性瑞士白化小鼠被随机分为对照组、剖腹术组和二氧化碳气腹组。在每只小鼠背部做一个15毫米的横向皮肤切口,用4.0聚丙烯线放置4根间断褥式缝线进行伤口缝合。剖腹术组进行正中剖腹术。以9 mmHg的腹腔内压力进行二氧化碳气腹。在60分钟结束时从腹腔排出残留气体。在术后第3、7和15天处死小鼠。测量伤口组织的伤口抗张强度和5-羟脯氨酸浓度。
随着切口后时间的推移,切开皮肤的抗张强度增加。在整个观察期内,对照组、剖腹术组和二氧化碳气腹组切开皮肤的抗张强度之间没有显著差异。所有组的皮肤5-羟脯氨酸浓度在术后第3天没有显著差异。但与对照组相比,剖腹术组和二氧化碳气腹组在术后第7天和第15天的5-羟脯氨酸浓度较低(第7天和第15天P<0.02)。
二氧化碳气腹和剖腹术降低了伤口的5-羟脯氨酸浓度,提示伤口愈合能力下降。