Collagen metabolism in infected colonic anastomoses.

Infection of the peritoneum has an adverse effect on the healing of colonic anastomoses. It has been suggested that infection results in a disturbance of colonic collagen metabolism, but the precise nature of the biochemical disorder is uncertain. Colonic collagen metabolism was studied in infected anastomoses in the left colon of rats. The rats were labeled with radioactive proline from an early stage of growth, and infected anastomoses were compared with anastomoses of the control group of uninfected rats. Infection resulted in significant changes in collagen metabolism during the early phase of colonic healing. There was a significant reduction in the amount of salt soluble collagen in infected anastomoses on the third postoperative day compared with anastomoses of the control group, and reduced amounts of acid soluble collagen and insoluble collagen were found in infected anastomoses on the seventh postoperative day. These observations suggest that the defective healing of infected colonic anastomoses results either from an increased lysis of newly formed--salt soluble--collagen or from a reduction in the intracellular formation of collagen.