Vascular Compromise in Experimental Colonic Anastomoses

Successful anastomotic healing depends upon adequate tissue blood flow. More than one in ten colonic anastomoses leak causing death in one-third of patients.The benefits of vaso-active agents in intestinal ischaemia has been previously reported. In this study isoxuprine and nifedipine were administered to rats un dergoing colonic anastomosis in normal and ischaemic bowel and the effect on healing was noted. Similarly the effect of intestinal obstruction on colonic blood flow was measured using a laser Doppler flowmeter.Although both isoxuprine and nifedipine appear to improve early healing, Nifedipine may actually impair the later stages as collagen content is signifi cantly reduced at seven days. Intestinal obstruction significantly reduced co lonic blood flow in proximal bowel after three days and flow took longer to recover in this segment than in the distal collapsed colon.Adequate tissue perfusion is a pre-requisite for normal healing.