Hastings J C, Winkle W V, Barker E, Hines D, Nichols W
Surg Gynecol Obstet. 1975 May;140(5):701-7.
Wound healing in the stomach and colon of mongrel dogs was studied using physical, histologic and chemical techniques to evaluate effects of various suture materials on the healing pattern and to compare visceral wounds with skin wounds. The general pattern of healing for stomach and colon wounds is the same in rats, rabbits and dogs. However, the extent of healing, the percentage of strength of normal tissue attained by the wound, is less in the dog than in the rat or rabbit. Prolene and plain and chromic catgut produce the least and silk produces the greatest cellular reaction in the stomach and colon. We believe the effect of absorbable sutures on strength of stomach and colon wounds, while statistically significant, is not of any great clinical significance except perhaps in severely debilitated patients. A trial of Prolene sutures for anastomotic closure would seem indicated. The healing of stomach and colon wounds differs from the pattern observed for skin wounds. Breaking strength increases rapidly for 14 to 21 days postwounding and then does not change significantly. The wounds are metabolically more active than skin wounds since the rate of collagen synthesis is markedly elevated even after 120 days and the rate of noncollagenous protein synthesis is twice as great in the wound as it is in normal tissue. Colon and stomach wounds closed with absorbable sutures are weaker at 14 through 28 days than similar wounds closed with nonabsorbable sutures. Yet, when strength of wound is expressed as a percentage of strength of unwounded tissue, there is no difference between wounds blosed with absorbable or nonabsorbable sutures. Thus, it would appear that there is a general diminution of the strength of normal stomach and colon wall up to 6 centimeters from wounds which have been closed with absorbable sutures.
采用物理、组织学和化学技术，研究了杂种犬胃和结肠的伤口愈合情况，以评估各种缝合材料对愈合模式的影响，并将内脏伤口与皮肤伤口进行比较。大鼠、兔子和狗的胃和结肠伤口的一般愈合模式是相同的。然而，狗的愈合程度，即伤口达到正常组织强度的百分比，低于大鼠或兔子。普理灵缝线以及普通和铬制肠线在胃和结肠中引起的细胞反应最小，丝线引起的细胞反应最大。我们认为，可吸收缝线对胃和结肠伤口强度的影响虽然在统计学上具有显著意义，但除了可能在严重虚弱的患者中外，没有太大的临床意义。似乎有必要试用普理灵缝线进行吻合口闭合。胃和结肠伤口的愈合与皮肤伤口的观察模式不同。伤口破裂强度在受伤后14至21天迅速增加，然后没有明显变化。伤口在代谢上比皮肤伤口更活跃，因为即使在120天后胶原蛋白合成速率仍显著升高，伤口中非胶原蛋白合成速率是正常组织的两倍。用可吸收缝线闭合的结肠和胃伤口在14至28天时比用不可吸收缝线闭合的类似伤口更弱。然而，当将伤口强度表示为未受伤组织强度的百分比时，用可吸收或不可吸收缝线闭合的伤口之间没有差异。因此，似乎在用可吸收缝线闭合的伤口周围6厘米范围内，正常胃和结肠壁的强度普遍降低。
