Comparison of two closure techniques for the repair of experimental colonic perforations

Background: Primary repair of penetrating wounds of the colon is gaining in creasing acceptance in surgical practice. This study compared two technique s for the repair of experimental colonic perforations in the presence of pe ritonitis. Methods: Multiple colonic perforations were created in the colon of 24 pigs . Following a 6-h delay the perforations were closed either by local excisi on and suture or by skin staples applied to the seromuscular layers of the colon. The repairs were assessed biomechanically and histologically for up to 14 days after surgery. Results: All animals had diffuse peritonitis at the time of colonic repair. Stapled repairs were completed significantly faster than sutured repairs ( mean(s.d.) 4.8(1.6) versus 30.7(4.0) min, P < 0.001). Biomechanical evaluat ion of repairs revealed no significant differences between the two techniqu es. Histological examination of repairs closed by staples demonstrated more advanced healing compared with suture closure, on the basis of tissue appo sition and inflammatory changes. Conclusion: Experimental colonic injuries may be treated successfully by pr imary repair in the presence of peritonitis. The use of skin staples for re pair does not appear to prejudice colonic wound healing.