Effects of corticosteroid on the healing bowel anastomosis

Conflicting results have been reported as to whether or not wound healing is retarded following treatment with corticosteroids. The surgical literature is lacking information on the effects of steroids on the healing bowel anastomosis. It has seemed reasonable to evaluate the bursting pressure, blood supply, and histologic changes of the bowel anastomosis in rats systemically pretreated with various doses of steroids. Male albino rats were pretreated with corticosteroids for 14 days in 20, 10, and 5 mg/kg of hydrocortisone acetate (intramuscular injection). A small bowel loop was divided and reanastomosed in each group (10 test and 5 control animals). The anastomosis was subsequently tested after 4, 5, 7, and 10 days. Three different methods of testing were used: 1) bursting pressure; 2) microangiography; and 3) histologic study. Large doses of 20 and 10 mg/kg of steroid deteriorated the test rats, significantly reducing the healing process within these 10 days as compared with the control rats. The 5 mg/kg group showed differences in bursting pressure only between the 4th and 7th postoperative days (statistical significance). Microangiography and histologic changes were not significant between the test and control rats. These results demonstrate decreased bursting pressure in steroid pretreated rats between the 4th and 7th postoperative days. These results may have implications regarding the care of steroid treated patients undergoing intestinal surgery.