ABSTRACT
Revascularization of ischemic bowel may induce further local tissue damage due to reperfusion injury. Therefore, we aimed to investigate the effect of ischemia reperfusion injury on the healing of intestinal anastomosis in experimental models. Thirty rabbits were divided equally into three groups: a control group [Group 1]; an ischemia group [Group II], in which only the superior mesenteric artery [SMA] was occluded for 30 minutes and a profound ischemia group [Group III] in which SMA was occluded as well as collateral vessels for 30 minutes. The pulsations were seen to return to marginal vessels and the bowels began to appear pinker and healthier in all groups following the restoration of arterial flow. Then all animals underwent a 3-cm ileal resection and primary anastomosis, 10 cm proximal to the ileocecal valve. Within each group, animals were anesthetized on the fifth postoperative day. Abdominal wound healing, intra-abdominal anastomotic complications, anastomotic bursting pressure measurements and hydroxyproline content were recorded. Anastomotic dehiscence was found in 1 in group II and in 5 in group III. The mean bursting pressures of the anastomosis was 158 mmHg in group I [control group], 150 mmHg in group II and 106 mmHg in group III while the mean hydroxyproline value content was 3.09 micro-mole/g tissue in group I, 2.91 micro-mole/g tissue in group II and 1.51 micro-mole/g tissue in group III, so there was no significant difference between group I and II while there was significant difference between group I, II and group III. We conclude that, even when the intestines are well perfused and viable after revascularization, one must bear in mind that intestinal reperfusion injury may compromise anastomotic healing