Intraoperative hemostasis and wound healing in intestinal anastomoses using the ILA stapling device.

ABSTRACT

Intraoperative hemostasis and wound healing of 24 side-to-side intestinal anastomoses constructed with the ILA stapling device were studied in 12 dogs by comparing the ILA-32 and ILA-52 staple cartridges. Hemostasis was evaluated by intraoperative measurement of blood loss and bleeding time at the staple line. There was no statistically significant difference in mean blood loss (p greater than 0.05) or mean bleeding time (p greater than 0.10) between the two cartridges. Wound healing was studied using bursting strength measurements and silicone rubber casting of the microvasculature at the staple line. At 3 days, 1 week, and 2 weeks postoperatively, there was no significant difference between bursting strength values achieved with the two cartridges. Microscopic examination revealed that wound healing in the ILA-52 anastomoses lagged behind healing in the ILA-32 anastomoses at each postoperative time period studied. The silicone rubber casting study showed a paucity of microvasculature at the healing staple line with the ILA-52 cartridge as compared with the ILA-32 cartridge. Our findings suggest that the ILA-52 cartridge does not offer significantly improved intraoperative hemostasis over the ILA-32 cartridge and may affect the microvasculature at the staple line in a way that delays wound healing.