Effect of Early Postoperative Nutritional Support on Skin Wound and Colon Anastomosis Healing

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Abstract
Improved healing occurs in nutritionally depleted rats given early postoperative compared with delayed feeding. The present study was designed to test the hypothesis that delay in postoperative feeding of rats normally nourished at the time of operation would also be detrimental to wound healing. Fully nourished rats weighing 288 to 342 g were divided into three groups (10 rats per group). All rats had central vein catheters inserted, celiotomy with division and reanastomsis of the colon and dorsal skin incisions, under ip pentobarbital anesthesia. With no oral intake allowed postoperatively, groupl rats were maintained on iv 5% Dextrose electrolytes and vitamins (5% DSV); group 2 was given the 5% D/SV until the third postoperative day when they were placed on TPN (4.5% amino acids 15% Dextrose, 10% Intralipids); and group 3 was given TPN from the first postoperative day. Rats were sacrificed 6 days postoperatively and final weight, skin wound breaking strength (WBS) and colon anastomosis bursting pressure (CBP) were measured. Findings were % weight change —27.8 ± 1.5 for Group 1, —12.6 ± 1.0 for Group 2, and -6.9 ± 8 for group 3 (p < 0.0001). Wound measurements for STS on fresh specimens were 88.6 ± 10.0 g for group 1, 89.1 ± 8.4 g for group 2, and 87.1 ± 11.1 g for group 3. WBS for formalin-fixed specimens were 313.5 ± 29.7 g for group 1, 323.4 ± 38.4 g for group 2, and 382 ± 25.2 g for group 3 (NS). CBP was 155.7 ± 6.2 mm Hg for group 1, 169.7 ± 2.7 mm Hg for group 2, and 192.3 ± 2.5 mm Hg for group 3 (p < 0.0001 for group 3 us groups 1 and 2). It can be concluded that early postoperative TPN has a significant beneficial effect on postoperative weight loss and colonic anastomotic healing. (Journal of Parenteral and Enteral Nutrition 14:357-361, 1990)