J.Jpn. Surg. Soc.. 81(3): 281-290, 1980

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Original article

EFFECT OF MALNUTRITION AND TOTAL PARENTERAL NUTRITION ON WOUND HEALING OF COLONIC ANASTOMOSES

Mongrel dogs weighing 7 to 10 kg were grouped as follows, (1) I-A: fed freely with dog foods before and after colonic anastomosis, (2) I-B: fed freely with dog foods before colonic anastomosis and starved for 1 week after that, (3) II: starved for 2 weeks before and 1 week after colonic anastomosis,(4) III-A: starved for 3 weeks before and 1 week after colonic anastomosis, (5) III-B: starved for 3 weeks before and fed by total parenteral nutrition (TPN: 100 cal/kg/day, amino acids 2.5 g/kg/day) for 1 week after colonic anastomosis, (6)III-C: starved for 3 weeks before and fed by 1/2 TPNf or 1 week after colonic anastomosis, (7) III-D: starved for 3 weeks and fed by TPN for 1 week before colonic anastomosis,then starved for 1 week afterward.
Results:
I) Preoperative TPN for I week was associated with a significant improvement in amounts of circulating albumin.
2) The significant reduction in bursting strength in III-A was resumed to almost normal range in III-B and III-C where TPN with full strength or half strength were performed.
3) Collagen content in tissue of the colonic anastnosis in III-B was increased over I-A and I-B.
These results indicate that preoperative or postoperative TPN improves the state of malnutrition and facilitates wound healing in malnourished state.

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