Dawson D L, Coil J A, Jadali M, Garrett G
Iowa Methodist Medical Center, Des Moines, IA 50309.
J Trauma. 1992 Feb;32(2):204-9. doi: 10.1097/00005373-199202000-00016.
Undocumented reports exist concerning use of skin staplers to close small perforations of the gut. This study examined use of this device in experimental gastrointestinal injuries in dogs. In 18 anesthetized mongrel dogs, matching uniform perforations were made with a sterile leather punch; one perforation of each pair was closed with 3-0 silk and the other with a skin stapler. A total of 80 stomach, 238 small intestine, and 140 colon perforations were created. Hole sizes progressed from 1.9 to 5.0 mm. Unrepaired intestinal wounds leaked and were lethal. No leaks were identified in wounds closed with either sutures or staples provided that closure was complete. Speed of staple closure was faster than that of suture closure (1.2 vs. 16.0 seconds), but ease of closure was similar. It is concluded that skin staplers are safe for repair of small wounds, created under ideal conditions, in canine gastrointestinal tracts. Similar injuries in traumatized humans deserve study, but existing skin staplers may be ineffective for human intestine since gut wall thickness in humans is less than that in dogs.
关于使用皮肤吻合器闭合肠道小穿孔有一些未经证实的报道。本研究检测了该器械在犬类实验性胃肠损伤中的应用。在18只麻醉的杂种犬身上，用无菌皮革打孔器制造匹配的均匀穿孔；每对穿孔中一个用3-0丝线闭合，另一个用皮肤吻合器闭合。共制造了80个胃穿孔、238个小肠穿孔和140个结肠穿孔。孔的大小从1.9毫米到5.0毫米不等。未修复的肠道伤口会渗漏并导致死亡。只要闭合完整，用缝线或吻合器闭合的伤口均未发现渗漏。吻合器闭合的速度比缝线闭合快（1.2秒对16.0秒），但闭合的难易程度相似。得出的结论是，在理想条件下，皮肤吻合器用于修复犬类胃肠道中的小伤口是安全的。受创伤人类的类似损伤值得研究，但现有的皮肤吻合器对人类肠道可能无效，因为人类肠壁厚度小于犬类。
