Suturas gastrointestinales

Abstract

La síntesis de las heridas gastrointestinales ,requiere, que las suturas adosen los labios por la cara serosa, cohíban la hemorragia y cierren la cavidad, es decir, que sean invaginantes, hemostáticas y herméticas. Hace algún tiempo, revisando piezas de gastroenteroanastomosis y gastrectomía en perros sacrificados precozmente, observamos grandes diferencias en el interior de las bocas, según se tratara de la vertiente posterior o anterior. Como en la primera se practica corrientemente el procedimiento de Lembert- Czerny y en la otra la tendencia a la eversión de la mucosa exige el empleo de suturas tipo Connell o Schmieden, pensamos que esa fuera la causa de las diferencias anotadas en favor de la vertiente posterior. Así surgió la idea de este trabajo repetido por muchos experimentadores, destinado a comparar los resultados de las suturas más usadas en cirugía gastrointestinal.

We experimented in 15 dogs the most used sutures in gastrointestinal surgery. We practise in the stomach transversal incisions which were sutured according to 4 technics and using several niaterail of suture. The animals were put to death the first, second and third week and the injuries were studied macroscopical and microscopically. in their peritoneal face, the injuries presente always good looking, having employed any one of the technics. In their mucous face, the injuries looked very different according to the technic used. We get the best results with the common surjet in 2 planes. With Connell’s suture the results were constantly bad and we could observed in the first and second week defects in the cicatrization and deep and extended ulcers. With Schmieden ’s suture, we also observed often, defects in the injury but not so dangeroues and extended as with Connell’s one. According to their experiences, the authors consider that Connell and Schmieden’s sutures are not advised and they prefer, in man, the classic “ surjet ” in 2 planes.