Application of intestinal connection device on the intestinal rupture with shock in a dog model

Objective To determine the feasibility of the self-developed intestinal connection device (ICD) in a intestinal rupture of Beagle with hemorrhagic shock model. Methods 10 beagle dogs were randomly divided into two groups. Dogs were subjected to intestinal transections and arterial bloodletting to establish intestinal rupture with hemorrhagic shock model. In experimental group (n=5), the broken intestine was reconstructed using ICD, and the broken intestine in control group (n=5) was ligated by suture. Then abdominal cavity was temporarily closed. 48 h after surgery, definitive surgery was performed. Related parameters of damage control surgery (DCS) (operation time, the time spent in managing each resection, blood loss and fluid resuscitation within the first 24 h), intraoperative situation of definitive surgery and survival situation of dogs were recorded.0, 1, 2, 4, 8, 24 h after DCS, the endotoxin concentration was detected. The upper digestive tract was examined in the animals of experimental group. In definitive operation, the terminal ileum tissue was removed for pathological examination. Results There was no statistical difference between the experimental group and the control group in the operation time of the damage control surgery [(37.82±11.83) min vs. (38.85±12.90) min], the time spent in managing each resection [(5.09±1.46) min vs. (4.45±1.28) min], blood loss [(364.45±37.92) min vs. (372.54±43.43) min] and fluid resuscitation within the first 24 h [(1 686.87±157.69) min vs. (1 729.58±176.23) min]. In definitive surgery, intestinal blood supply in experimental group was rich, but the intestines in control group showed ischemic change.24 h after definitive surgery, all the animals in the experimental group survived, but only 2 in the control group. 4 h since DCS, the concentration of endotoxin in the control group was significantly higher than that of the experimental group (P<0.05). Digestive tract radiography showed the intestines in experimental group were reserved good patency. Microscopic examination showed the terminal ileum tissue in experimental group was subjected to more slight inflammation change. Conclusion In severe trauma, the use of ICD for reconstruction of broken bowel is feasible, which can retain the physiological function of the intestine and reduce endotoxin translocation and intestinal injury. Key words: Intestinal rupture; Hemorrhagic shock; Intestinal reconnecting; Intestinal ligation; Endotoxin translocation