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Neutrophil-induced decrease in wound margin strength after intestinal anastomosis--influence on collagen and
H Högström1, L Bondeson, U Haglund
1Department of Surgery, Lund University, Malmö General Hospital, Sweden.
Summary
Post-surgery wound healing involves a decrease in tissue strength, but not due to collagen changes. Proteinase inhibitors and free-radical scavengers counteract this strength loss by acting on neutrophils, not by reducing their numbers.
Area of Science:
- Wound healing research
- Gastrointestinal surgery
- Biomedical engineering
Background:
- Surgical incisions lead to early decreases in adjacent tissue strength.
- Neutrophils, proteinase inhibitors, and oxygen-free radicals are implicated in this strength reduction.
Purpose of the Study:
- To investigate the mechanisms behind the early decrease in intestinal anastomosis strength after surgery.
- To determine if proteinase inhibitors and oxygen-free radical scavengers reduce strength loss by affecting neutrophil accumulation.
Main Methods:
- Measurement of collagen and histological examination in rat intestinal anastomosis.
- Assessing neutrophil accumulation using myeloperoxidase (MPO) assay and histology.
- Evaluating the effects of soybean trypsin inhibitor (STI) and superoxide dismutase (SOD)/catalase treatment.
Main Results:
- Decreased tissue strength did not correlate with collagen levels or solubility.
- Myeloperoxidase (MPO) activity significantly increased 24 hours post-surgery in saline-treated rats.
- Neither STI nor SOD/catalase treatment affected MPO activity or neutrophil accumulation histologically.
Conclusions:
- The early decrease in intestinal anastomosis strength is not directly related to collagen changes.
- Proteinase inhibitors and oxygen-free radical scavengers mitigate strength loss through mechanisms other than reducing neutrophil infiltration.
- These agents may act by locally inhibiting neutrophil proteolytic enzymes and oxygen-free radicals at the wound site.