April 1988

Prevention of Contraction of Patched Intestinal Defects

Author Affiliations

From the Omaha Veterans Administration Hospital (Dr Thompson) and the Departments of Surgery (Dr Thompson and Mr Hollingsed) and Anatomy (Dr Saxena), University of Nebraska and Creighton University School of Medicine, Omaha.

Arch Surg. 1988;123(4):428-430. doi:10.1001/archsurg.1988.01400280034006

• Neomucosal growth on a serosal patch might increase intestinal surface area in the short-bowel syndrome but is limited by contraction of the patched defect. Our aim was to reduce contraction by mechanical or pharmacologic means. Ileal defects (2×5 cm) were patched with colon serosa in 14 rabbits. Group 1 (n=5) had a plastic splint sutured to the defect edge. Group 2 (n=4) received hydrocortisone acetate and vitamin A. Group 3 (n=5) was the control group. Four weeks after patching there was significantly less contraction in groups 1 and 2 compared with group 3 (72.3%±5.6% and 50.0%±5.8% vs 31.9%±1.8% initial defect size). Epithelial coverage of the defect was greater in groups 1 and 3 than in group 2. Disaccharidase activity of neomucosa and surrounding mucosa was significantly decreased in the steroid-treated rabbits. Contraction of a serosal patch can be reduced by mechanical and pharmacologic measures that may enhance the clinical applicability of this technique.

(Arch Surg 1988;123:428-430)