Prevention of contraction of patched intestinal defects

J. S. Thompson, T. C. Hollingsed and S. K. Saxena
Omaha Veterans Administration Hospital, NE.

Neomucosal growth on a serosal patch might increase intestinal surface area in the short-bowel syndrome but is limited by contraction of the patched defect. Our aim was to reduce contraction by mechanical or pharmacologic means. Ileal defects (2 x 5 cm) were patched with colon serosa in 14 rabbits. Group 1 (n = 5) had a plastic splint sutured to the defect edge. Group 2 (n = 4) received hydrocortisone acetate and vitamin A. Group 3 (n = 5) was the control group. Four weeks after patching there was significantly less contraction in groups 1 and 2 compared with group 3 (72.3% +/- 5.6% and 50.0% +/- 5.8% vs 31.9% +/- 1.8% initial defect size). Epithelial coverage of the defect was greater in groups 1 and 3 than in group 2. Disaccharidase activity of neomucosa and surrounding mucosa was significantly decreased in the steroid-treated rabbits. Contraction of a serosal patch can be reduced by mechanical and pharmacologic measures that may enhance the clinical applicability of this technique.