Hastings J C, Van Winkle W, Barker E, Hines D, Nichols W
Surg Gynecol Obstet. 1975 Jun;140(6):933-7.
The healing pattern of bladder tissue and its response to various suture materials were studied and compared with data reported previously on skin, stomach and colon wounds. Tensile strength, biochemical data and histologic reactions were used as parameters of wound healing measurement. The healing pattern of urinary bladder wounds resembles that observed for stomach and colon. However, wounds of the urinary bladder wall regain strength equal to unwounded bladder wall within 21 days, whereas wounds of stomach and colon do not achieve more than 70 per cent of unwounded tissue strength after 120 days. The rate of collagen synthesis in bladder wounds reaches a peak at five days and returns to that of normal unwounded tissue by 70 days. Colon and stomach wounds, on the other hand, showed elevated rates of collagen synthesis even at 120 days. As with colon and stomach, absorbable sutures appear to lower the strength of both the wound and unwounded tissue. However, in stomach and colon this effect is only observed during the first 21 days of healing; in the bladder it persists throughout the 120 day observation period. No histologic evidence of smooth muscle regeneration was seen in bladder wounds. Noncollagenous protein synthesis was not increased in the wound, also suggesting smooth muscle regeneration does not occur. Silk and Mersilene sutures produced the greatest tissue reaction; if the sutures were exposed in the lumen of the bladder, stone formation was observed. This was not observed with monofilament polypropylene sutures. Plain catgut produced the least tissue reaction, but both plain aions comparable with chromic catgut but were regularly absorbed between 28 and 70 days. Since the bladder is well healed by 21 days, polyglactin-910 may be an ideal suture for use in the bladder.
研究了膀胱组织的愈合模式及其对各种缝合材料的反应，并与先前报道的皮肤、胃和结肠伤口的数据进行了比较。将拉伸强度、生化数据和组织学反应用作伤口愈合测量的参数。膀胱伤口的愈合模式类似于胃和结肠的愈合模式。然而，膀胱壁伤口在21天内恢复的强度等于未受伤的膀胱壁，而胃和结肠伤口在120天后恢复的强度不超过未受伤组织强度的70%。膀胱伤口中胶原蛋白合成的速率在五天时达到峰值，并在70天时恢复到正常未受伤组织的水平。另一方面，结肠和胃伤口即使在120天时胶原蛋白合成速率仍升高。与结肠和胃一样，可吸收缝线似乎会降低伤口和未受伤组织的强度。然而，在胃和结肠中，这种影响仅在愈合的前21天观察到；在膀胱中，这种影响在整个120天的观察期内持续存在。在膀胱伤口中未发现平滑肌再生的组织学证据。伤口中非胶原蛋白的合成没有增加，这也表明平滑肌没有再生。丝线和聚酯缝线产生的组织反应最大；如果缝线暴露在膀胱腔内，会观察到结石形成。单丝聚丙烯缝线则未观察到这种情况。普通肠线产生的组织反应最小，但两者与铬制肠线相当，但在28至70天内会定期吸收。由于膀胱在21天时已愈合良好，聚乙醇酸-910可能是用于膀胱的理想缝线。
