EFFECT OF INTERRUPTED AND CONTINUOUS SUTURING ON INTESTINAL WOUND MARGIN STRENGTH IN RATS

Suture-holding capacity (breaking strength) of small bowel anastomoses made with interrupted or continuous sutures was assessed in two group s of rats. The tightness of the suture line was varied in a standardiz ed manner in both groups. All types of anastomoses had similar strengt h immediately after surgery. After 72 h, suture-holding capacity had d ecreased by 50-55% (p < 0.001) in tightly sutured anastomoses and by 1 0-15% (p > 0.05) if sutures were loose. Changes in strength were simil ar regardless of whether interrupted or continuous sutures were used. Myeloperoxidase activity, reflecting tissue neutrophil accumulation, a nd hydroxyproline content were similar in all types of anastomoses aft er 72 h. Deterioration of early anastomotic strength is probably due t o proteinase-mediated tissue degradation. It is speculated that tight sutures encourage proteolytic enzyme activity in the bowel wall by dis turbing the local proteinase/proteinase inhibitor balance.