The effect of trauma on colonic healing

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Abstract
Clinical studies have shown that bloody or traumatic colonic operations are associated with a high incidence of anastomotic dehiscence, and it has been suggested that trauma has important systemic effects on colonic healing. However, intra-abdominal trauma may have important local effects on colon healing, and the pathogenesis of anastomotic disruption in traumatized subjects remains uncertain. The effects of local and remote trauma were studied in colonic anastomoses in rats. Local trauma consisted of a retroperitoneal dissection and biopsy of the psoas muscle, and some animals were given peritoneal drains. Remote trauma consisted of a comminuted fracture of the femur. Remote trauma had no effect on the tensile strength and collagen content of colonic anastomoses, but local trauma in the vicinity of anastomoses resulted in loss of colonic tensile strength and a significant incidence of anastomotic disruption. The incidence of anastomotic disruption was not significantly affected by peritoneal drains. Anastomotic dehiscence in traumatized animals was accompanied by a significant reduction in the collagen content and collagen concentration of anastomoses. It is concluded that sepsis is the most probable cause of the failure of anastomotic healing in traumatized animals.