Authors: Jens Hoeppner Vladan Crnogorac Goran Marjanovic Eva Jüttner Wojciech Karcz HansFred Weiser Ullrich Theodor Hopt
Publish Date: 2008/09/03
Volume: 13, Issue: 1, Pages: 113-119
Abstract
Small intestinal submucosa SIS has proved considerable regenerative capacity for repair of bowel wall defects at different locations This study assesses the effectiveness of SIS in the repair of defects at a gastrointestinal location with strong bacterial contaminationFourteen domestic pigs had a 45 × 15 cm fullthickness defect created on the wall of the descending colon Repair was done by suturing an SIS patch to the defect Grafts were harvested after 30 60 and 90 days Outcomes were evaluated on the basis of animal survival clinical course and macroscopic histological and immunohistochemical assessmentAll animals survived the scheduled observation period No patch failure and no postoperative leakage occurred No luminal narrowing occurred at SISpatched colon Morphometric examination revealed contraction of the patched area of 77 after 30 days and more than 90 after 60 and 90 days By 60 and 90 days all animals showed mucosal regeneration at the margins of the graft By 90 days regeneration of smooth muscle cells was present at the original site of the muscularis mucosae None of the reconstructed areas showed complete mucosal coverage or regeneration of a structured muscular layerSIS can be used effectively for patch repair of colonic defects in a porcine model Distinctive contraction of the reconstructed area and limited architectural regeneration of the bowel wall suggest limitation of morphologic regenerative capacities in largebowel regeneration
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