Accelerated wound healing with stapled enteric suture lines. An experimental study comparing traditional sewing...

The healing of 3-cm longitudinal colotomies closed with either Czerny-Lembert suture lines (CLSL) or TA-30 staple lines (SSL) were studied in 28 mongrel dogs using bursting strength (BS) measurements. Dogs from each group were sacrificed on postoperative days (POD) 1 through 7. Mean BS for the SSL in all 14 dogs was 165 mmHg +/- 64 and for CLSL 80 mmHg +/- 49 (DF = 13; t = 5.5672; p less than 0.00005 for matched pairs). For POD 2 through 5, BS of the SSL was 154 mmHg +/- 42, three times greater than the BS of the CSLS, which was 54 mmHg +/- 33 (DF = 7; t = 5.6289; p less than 0.0004 for matched pairs). BS of the SSL increased linearly from the first day of surgery: BS (mmHg) = 26 (POD) + 61 (n = 14; r = 0.838; p less than 0.01). BS of the CLSL followed the traditional pattern of wound healing dropping to a nadir after 3 days and then increasing linearly: BS (mmHg) = 32 (POD) - 72 (n = 10; r = 0.834; p less than 0.01). Microscopic examination revealed a greater inflammatory response to the CSLS than the SSL. Differences were most marked from 2 to 4 days following operation. Thus, the SSL healed more rapidly than the CLSL as measured by BS. The SSL healed with a negligible Lag Period of wound healing entering directly into the Period of Fibroplasia.