TISSUE STRUCTURES REPARATION FEATURES IN THE GUT ANASTOMOSES DURING 90 DAYS PERIOD AFTER CREATING BY LIVE TISSUES WELDING TECHNOLOGY

Abstract

The bacterial inflammation obligatory arises after ischemic necrosis under the sutures in the intestinal wall inside uncomplicated intestinal anastomosis. It determines the healing type causes cicatricial replacement of intestinal tissue, additionally supported by suture material encapsulation and rejection process.

The aim of the study – to investigate the tissue structures reparation features in the intestinal anastomosis, created by using the Live Tissues Electric Welding Technology, during the period of tissue reparation and scar origin.

Materials and Methods. Changes in intestinal anastomoses were studied after 4, 7, 21, 45 and 90 days after its creation from the positions of gut wall tissues structure reparation. A circular electrowelded small intestinal anastomosis was applied in 18 pigs in a chronic experiment. The electric welding devices EK-300M1 and Patonmed-300 were used, as well as prototypes of surgical instrument for circular intestinal anastomoses creating. The hematoxylin-eosin and Van Gieson histopathologic techniques were used.

Results and Discussion. In 7 days, the strength of the welded anastomosis exceeds 220 mm Hg, because outstanding tissue was ruptured. The signs of tissue structure reparation appeared: the welded zone thinning with symmetrical approach of the visually unaltered areas of anastomosed intestines, compared to 4 days. Also, differently directed at 4 day collagen fibers are becoming orientation and bundles formation. The young connective tissue comprised a wide network of newly formed functioning blood arteriols. In 21 day none inflammatory sign was present. Fibrous connective tissue networks the separate muscle bundles, and penetrates 5 mm into the connected gut edges. Various ranges of vessels yet formed and functions. In 45 days tissue thickening due to membranes collagenization as well as muscle layers, arteries and veins coverage by collagen fibers are noted. The vessels pass right through the welding anastomose line, and are quickly coloured. In 90 days, the fibrous network has not tend to merge into a continuous scar, and the anastomose line can be determined only by network expression around individual smooth muscle fibers, and by point of fibers tangential orientation change. The mucosal folds are restored up to line.

Conclusions. The frame continuity of the anastomosed intestinal walls, which is restored at the electric welding site is a prerequisite for the rich capillary blood supply and symmetrical restoration of the tissue structure of the intestinal wall after 7 days. The foreign bodies and microorganisms absence in the welded intestinal anastomosis structure leads to inflammation components disappearance during 21 days, which also provides the scar structure formation in delicate pathway, avoiding cicatrix tissue replacement.