Small intestinal submucosa (SIS) in the repair of a cecal wound in unprepared bowel in rats.

PURPOSE: Porcine-derived small intestinal submucosa (SIS) has been accepted as an acellular matrix for tissue regeneration. However, its use for remodeling gastrointestinal defects has been poorly investigated. Our previous study of the rodent stomach has demonstrated that the SIS stimulates regeneration of native tissue under acidic conditions. The purpose of this paper was to investigate the feasibility of using SIS as a bioscaffold for a colonic defect in unprepared bowel. METHODS: A 1 x 1-cm whole layer was excised on the anterior wall of the cecum in 24 rats, followed by onlay repair with SIS. Measurement outcomes included animal survival, mesh stability in situ, and histologic evaluation at 3 weeks and 6 months. RESULTS: Rats showed a significant weight gain and had no evidence of postoperative leakage. All wounds were secured and associated with either omental or other fatty adhesions. Histological findings revealed that intact mucosa covered the area of the graft in all cases 6 months after surgery and that the defect was completely replaced by the normal constituents (mucosa, muscle, and nerve cells) of the bowel wall. CONCLUSIONS: SIS was largely successful in promoting healing in a cecal wound in unprepared bowel and serving as a bioscaffold for regeneration of the native colonic tissue. Small intestinal submucosa may be useful in surgical anastomoses to promote healing and presumably prevent leakage.

Duke Scholars

Author Theodore N. Pappas Surgery, Minimally Invasive Surgery