Effect of hemorrhagic shock on intestinal anastomoses’ healing

Abstract

Background/Purpose: Hypovolemia and shock is increasingly frequent in the perioperative of intestinal anastomoses, especially due to abdominal trauma. The aim of this study is to evaluate the effects of hemorrhagic shock in the healing of intestinal anastomoses in rats. Methods: It was analyzed the shock interference on the strength of ileum anastomoses. Histologically, structural changes of the anastomotic segments were assessed by two pathologists. Data are given as mean ± SEM. The animals were randomly selected and assigned in two groups with six rats each: Group 1 - rats with hypovolemic shock (shocked+enterectomy) treated with fresh whole blood. Group 2 - rats not shocked, untreated + enterectomy. Results: The intestinal anastomosis bursting pressure of shock+enterectomy group rats was lower than in the unshocked+enterectomy group, and the difference was significant (p=0.001). In the hemorrhagic shock+enterectomy group rats the density of collagen and fibrous tissue was lower and inflammation/foreign body reaction was higher than in the unshocked+enterectomy group, featuring a more immature and deficient healing. Conclusion: In conclusion, the results show that the hypovolemic shock affects the ileum wound healing, causing a decrease in the bursting pressure (mmHg) of ileal anastomosis, leading to the fragility of the surgical wound.