Effect of omentopexy on wound healing of the extensively detached and anastomosed canine trachea.

Abstract

To examine the beneficial effect of omentopexy for tracheal anastomosis after extensive detachment that may cause impairment of the blood supply, the time course of tracheal wound healing was studied experimentally. Circumferential resection of the trachea for three cartilage rings (nos. 11, 12, 13) and end-to-end anastomosis of the trachea were performed in 66 mongrel dogs, which were allocated to three groups (n = 22 in each). In the detached group, the trachea was entirely mobilized and isolated from the surrounding tissue for a length of 25 cartilage rings. In the wrapped group, omentopexy was added for the anastomosed site. In the control group, the same anastomosis was performed without omentopexy or detachment. The tracheal tissue blood flow was measured with a laser Doppler flow meter at the anastomosed site, and the tensile strength was determined with a tensiometer. All groups showed significant decreases in the blood flow on day 3, compared with the preoperative values, and increases stepwise from day 7 to day 21. On days 3, 7, and 14 the tissue blood flow was significantly (p < 0.01) higher in the wrapped group than in the detached group, although on day 21 it did not differ significantly among the three groups. The tensile strengths of the cartilaginous and membranous portions were significantly (p < 0.05) higher in the wrapped and control groups than in the detached group. On day 21, no significant intergroup differences were observed for this parameter. In the wrapped group and in the control group, the capillary network at the anastomosed site was well developed on day 7, and the tracheal mucosal epithelium was well regenerated on day 21 without granulation formation. This study showed that omentopexy at the anastomosed site of an extensively detached trachea provided adequate wound healing caused by rapid recovery of the tissue blood flow.