Temple W J, Voitk A J, Snelling C F, Crispin J S
Ann Surg. 1975 Aug;182(2):93-7. doi: 10.1097/00000658-197508000-00001.
Although it is known that malnutrition hinders early wound healing, it has not been determined whether this occurs because of formation of a poor scar or a slow rate of normal healing; the ultimate fate of the malnourished wound is unknown. Malnutrition was produced in rats by short gut syndrome. Elemental diet was compared to rat chow and silk was compared with polyglycolic acid suture. Nutritional deficiency was seen in short gut rats for two weeks postoperatively. Thereafter adaptation allowed partial recovery, but relative deficiency persisted. Morbidity and mortality of short gut rats doubled that of controls and all wound complications were limited to this group, occurring within the first two weeks. Malnourished animals surviving for 60 days had wound strength equal to the control rats as determined by gut anastomosis bursting strength, skin wound breaking strength and wound hydroxyproline content. Neither diet nor suture material altered ultimate wound strength. Improved nutrition allowed more animals and wound to survive, but ultimate healing survivors was indistinguishable from that of normal controls. Thus early weakness probably results from slow healing rather than formation of poor scar. Nutrition plays an important role in early strength and survival, but not in ultimate wound healing.
虽然已知营养不良会阻碍伤口早期愈合，但尚未确定这是由于形成了质量差的瘢痕还是正常愈合速度缓慢所致；营养不良伤口的最终转归尚不清楚。通过短肠综合征在大鼠中造成营养不良。将要素饮食与大鼠饲料进行比较，并将丝线与聚乙醇酸缝线进行比较。术后两周内，短肠大鼠出现营养缺乏。此后的适应性变化使营养状况部分恢复，但相对缺乏仍然存在。短肠大鼠的发病率和死亡率是对照组的两倍，所有伤口并发症都局限于该组，且发生在最初两周内。通过肠吻合口破裂强度、皮肤伤口断裂强度和伤口羟脯氨酸含量测定，存活60天的营养不良动物的伤口强度与对照大鼠相当。饮食和缝线材料均未改变伤口的最终强度。营养状况改善使更多动物和伤口得以存活，但最终愈合的存活者与正常对照组并无差异。因此，早期伤口愈合缓慢可能是由于愈合速度慢而非形成质量差的瘢痕所致。营养在早期伤口强度和存活方面起着重要作用，但对伤口的最终愈合并无影响。
