Abstract

BackgroundThe myofibroblasts play a central role in wound healing throughout the body. The process of wound healing in the colon was evaluated with emphasis on the role of myofibroblasts.MethodsOne hundred male Wistar rats weighing 274 ± 9.1 g (mean age: 3.5 months) were used. A left colonic segment was transected and the colon was re-anastomosed. Animals were randomly divided into two groups. The first group experimental animals (n = 50) were sacrificed on postoperative day 3, while the second group rats (n = 50) were sacrificed on postoperative day 7. Healing of colonic anastomosis was studied in terms of anastomotic bursting pressure, as well as myofibroblastic reaction and expression of α-smooth muscle actin (α-SMA), adhesion formation, inflammatory reaction and neovascularization.ResultsThe mean anastomotic bursting pressure increased from 20.6 ± 3.5 mmHg on the 3rd postoperative day to 148.8 ± 9.6 Hg on the 7th postoperative day. Adhesion formation was increased on the 7th day, as compared to the 3rd day. In addition, the myofibroblastic reaction was more profound on the 7th postoperative day in comparison with the 3rd postoperative day. The staining intensity for α-SMA was progressive from the 3rd to the 7th postoperative day. On the 7th day the α-SMA staining in the myofibroblats reached the level of muscular layer cells.ConclusionsOur study emphasizes the pivotal role of myofibroblasts in the process of colonic anastomosis healing. The findings provide an explanation for the reduction in the incidence of wound dehiscence after the 7th postoperative day.

Highlights

  • The myofibroblasts play a central role in wound healing throughout the body

  • Healing of colonic anastomosis was studied in terms of anastomotic bursting pressure, as well as myofibroblastic reaction and expression of a-smooth muscle actin (a-SMA), adhesion formation, inflammatory reaction and neovascularization

  • The mean anastomotic bursting pressure increased from 20.6 ± 3,5 mmHg on the 3rd postoperative day to 148.8 ± 9.6 mmHg on the 7th postoperative day

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Summary

Introduction

The myofibroblasts play a central role in wound healing throughout the body. Healing of full-thickness injury to the gastrointestinal tract remains an unresolved topic. It begins with a surgical reapposition of the bowel ends, which is most often the initial step in the repair process. The myofibroblasts play a central role in the process of wound healing [1,2,3,4,5] They contain smooth muscle myosin isoforms in addition to a-smooth muscle actin (a-SMA), the requisite machinery for contraction and/or motility, respond to proinflammatory cytokines with elaboration of matrix proteins and additional growth factors and disappear by apoptosis following repair or scar formation [6,7,8,9,10,11].

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