Abstract

Abstract An experimental study in rabbits demonstrates that a significant postoperative decrease in bursting wall pressure is associated with a similar reduction in the colonic collagen from around the anastomosis. Mature collagen is broken down by the action of specific enzyme collagenase. This has been estimated by a tissue-culture method and is produced by viable explants of mucosa. There is a significant increase in the amount of this enzyme produced post-operatively and it is suggested that this is responsible for the decrease in collagen and weakness of the colon. An increased amount of enzyme is produced by explants from the colon than from those of other parts of the gastro-intestinal tract. This is regarded as an important reason for the high incidence of colonic and rectal anastomotic breakdown compared with breakdown of anastomoses in other parts of the gastro-intestinal tract. Following colonic anastomosis there is increased collagenase production not only locally but throughout the gastro-intestinal tract, suggesting that wound healing is not only under local control.

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