Temporary Intestine Reconstruction As A Damage Control Surgery Adjunct In Canine Hypothermic Shock Model With Bowel Perforations

Objective:This study builds the model of intestinal injury for canine hypothermic traumatic shock, to verify the feasibility of DCS to temporary reconstruction bowel during the initial operation, evaluate the difference between the temporary reconstruction and the traditional ligation method for intestinal mucosal barrier and contrast the changes in endotoxin translocation and inflammation levels so as to prolong the time for definitive bowel reoperation afterwards,which will save precious time for prior processing of the other important visceral organs in the gunshot wound.Methods:Eight male bego Canine with multiple bowel injury and exsanguination were randomly divided into two groups( 4each) : temporarily reanastomosed with a silicon tube(RA)and Multiple resection and ligatation(RL)groups,Laparotomy was performed after transfusion of appropriate amount of autologous blood and fluid infusion. Multiple resection and ligatation(RL), including recision of invatalized bowel and ligation of remaining parts. while in RA group the canines intestine were resected and temporarily reanastomosed with a silicon tube. The operation time, blood loss and volume of fluid infusion were recorded. The hemodynamic parameters, arterial blood gases,coagulation parameters,inflammation and endotoxin level were examined. Canines were sacrificed 24 hours after operation, small intestine were harvested for histological observation.Results:No significant difference was detected in operation time, blood loss and mean arterial pressure(MAP) between the two groups. Compared with RL group, the amount of infusion was less(RA:6911.67 ±1256.37 ml VS RL:4636.67± 1008.75 ml,P<0.05). Canines in RA group showed lower inflammation and endotoxin level, and lower dagree of acidosis and coagulopathy. The tissue injuries and neutrophil infiltration were milder in RA group than in CS group.Conclusion:(1). Canine Hypothermic Shock with Bowel Perforations is a feasible model.(2). Temporarily reanastomosed with a silicon tube(RA), compared with Multiple resection and ligatation(RL), may reduce fluid infusion, accelerate correction of metabo licacidosis, coagulopathy and hypothermia, avoid aggravation of accessory injuries and systemic inflammatory response induced by reperfusion, and prevent multiple organs dysfunction syndrome.(3).Temporary reconstruction of bowel perforations at the stage of rapid control during damage control surgery can maintain clear passage of intestinal tract, reduce the damage on intestinal mucosal barrier and maximally retain functional bowel.