Search PubMed⌕ Search

Biomedical subjects

D J Leaper

Publications and source records attributed to D J Leaper.

At least 73 records · Page 4Linked to original sources
PubMed1985

The effect of antiseptics on the healing wound: a study using the rabbit ear chamber.

The effects of several antiseptic agents on granulation tissue were studied using rabbit ear chambers as models of the healing wound. This enabled us to study dynamically the action of these agents on the microcirculation of the wound. All the agents tested caused some adverse effect, but in the cases of hypochlorite antiseptics Eusol and Chloramine T, blood flow in the capillary circulation of the granulation tissue ceased and the process of repair was subsequently delayed. A laser Doppler flowmeter was used to measure these changes in local perfusion which reflected the toxic effects seen on microscopy of the ear chamber.

Animals↗
PubMed1985

Hypovolaemia and healing in colonic anastomoses.

Colonic anastomotic leakage is more common following emergency resections than after elective operations. Transient hypovolaemia, which is more likely to occur during emergency surgery, has been shown to impair collagen metabolism in abdominal and skin wounds but its effect on colonic anastomotic healing has not been previously examined. Acute intra-operative loss of 10 per cent circulating blood volume in rats significantly impaired collagen concentration in both ileocolic (P less than 0.02) and colocolic (P less than 0.05) anastomoses measured on the third postoperative day. This degree of blood loss did not significantly affect early anastomotic strength. Hypovolaemia leads to tissue hypoxia, and this in turn may lead to impaired anastomotic healing. Measurement of tissue oxygen tension may predict poor healing by identifying inadequate intestinal perfusion. Colonic pTO2 measured in rabbits was significantly lower than in small bowel (37 +/- 18 mmHg versus 42 +/- 18 mmHg; P less than 0.001), and fell significantly in colon following 10 per cent blood loss (P less than 0.001). We conclude that adequate intra-operative fluid replacement during colonic resection and anastomosis is a prerequisite for successful healing.

Animals↗
PubMed1985

Do magnetic fields influence soft tissue wound healing?--A preliminary communication.

Magnetic fields have been considered for treating many ailments over man's history. There have been many anecdotal unsupported claims for successful treatment of soft tissue injury although reports have been more substantive in the orthopaedic field. The widespread clinical and veterinary use of a light self-adhesive magnetic foil in Europe prompted this trial of experimental wound healing. One hundred and sixty Sprague-Dawley rats had a linear 2.5 cm incision or a circular 1 cm skin defect made over the mid-dorsal spine. Equal numbers were randomised to receive either a magnetic foil or a dummy (control) dressing. At three, seven, 10 or 14 days linear wounds were distracted using a tensiometer; open defects were measured, excised and assayed for collagen content; 14-day wounds were examined histologically. Although wound tensile strengths increased and open wounds decreased in size with increase of hydroxyproline, there were no statistically significant differences between treated or control animals. Although easy to apply the alternate magnetic foil (giving 400 Gauss at 7 mm) conferred no statistically significant effect on soft tissue healing.

Animals↗
PubMed1985

Anorexia nervosa and necrotizing colitis.

Anorexia nervosa is associated with a mortality approaching 5% in patients severely enough affected to warrant hospital care (Hsu, 1980). The main causes of death are inanition, electrolyte disturbances or suicide. We report here a case of necrotizing colitis associated with anorexia nervosa, an association which has not been described previously.

Adult↗
PubMed1985

Colonic ischaemia and anastomotic healing.

The leakage rate of colonic anastomoses may be as high as 13%. A good blood supply is of paramount importance. However tissue perfusion may be at risk in the elderly and in low colorectal anastomoses. We have tested the effect of isoxsuprine, an agent which reduces blood viscosity, and is an alpha-adrenergic antagonist and beta-adrenergic agonist, on the healing process in normal and ischaemic rat colon. Both bursting pressure and hydroxyproline concentration were significantly improved in compromised ischaemic colon in animals treated with isoxsuprine. Isoxsuprine may improve healing in poorly perfused colonic anastomoses.

Animals↗
PubMed1985

Functional aspects of ano-rectal vascularity.

The blood supply of the ano-rectum has been studied in cadaveric specimens by angiographic methods. The vascular anastomosis between the middle rectal and superior rectal vessels was found to be demonstrable on one side only. There appears to be a midline paucity of vessels in both the posterior and anterior rectal walls, and this may be important in the aetiology of anastomotic dehiscence in low anterior resection.

Anal Canal↗
PubMed1985

Laparotomy closure.

Successful closure and healing of the musculo-aponeurotic layers of the abdominal wall after laparotomy should now be expected as the norm. Attention to technique and materials for closure is associated with low rates of wound failure (burst abdomen and incisional hernia).

Abdominal Muscles↗
PubMed1985

An experimental study of the influence of magnetic fields on soft-tissue wound healing.

The influence of magnetized foil strips (Energy-Pak Ltd., Wolfhalden, Switzerland) on soft-tissue healing in the skin of laboratory rats was studied. Linear sutured wounds healing by primary intention have been assessed for tensile strength using Instron tensiometry, and open full-thickness defects healing by secondary intention have been analyzed for collagen content, histologic appearance, and rate of healing. Wounds were covered by the alternate magnetic Energy-Pak foil or by a dummy control. No differences in tensile strength, collagen content, histologic studies, or rate of healing were seen between the treated and control groups.

Animals↗
PubMed1985

Abdominal wound closure: a controlled trial of polyamide (nylon) and polydioxanone suture (PDS).

Two hundred and thirty three patients with major laparotomy wounds, either midline or transverse, were randomly allocated to mass closure using No 1 (BPC) polyamide (Nylon) or polydioxanone suture (PDS). Wounds were assessed during the hospital stay and postoperatively in outpatients, at six weeks and six months, for evidence of wound failure or wound infection. Two wound failures occurred in the PDS group (one burst abdomen and one incisional hernia) although neither was directly attributable to suture failure. The overall wound infection rate was 13.3%; 2.9% being major infections and the majority (two thirds) occurring in the PDS group. There were no reported wound sinuses or wound pain in either group at six months. Polydioxanone suture may be an alternative to polyamide for laparotomy closure but is associated with a higher, though not statistically significant, incidence of wound failure and infection.

Adult↗
PubMed1984

Prostaglandins in colonic anastomotic healing.

In this study we report the effects of flurbiprofen and prostaglandin E2 on anastomotic tensile strength, collagen synthesis, and collagenolytic activity which are in a particularly fine balance in colonic healing. Colonic anastomoses were fashioned in 150 Sprague-Dawley rats which were allocated to receive either 20 mcg prostaglandin E2 in 1 ml saline, 1 ml saline alone (control) intraperitoneally for three days post-operatively, or oral 2.5 mg/kg flurbiprofen daily. Anastomotic bursting pressures, collagen content and collagenolytic activity were measured at three, six, and ten days. It was found that prostaglandin E2-treated animals had significantly weaker anastomoses at three days (102 +/- 6.1 mm Hg; m +/- SEM) compared with the control (126 +/- 7.3; P less than 0.02) or flurbiprofen group (128 +/- 4.6; P less than 0.01) with no differences at six and ten days. Collagen levels were higher in flurbiprofen-treated rats at three days (9.7 +/- 0.2 micrograms hydroxyproline/mg tissue) compared with the control (8.1 +/- 0.4 micrograms/mg; P 0.01) or prostaglandin E2 group (7.2 +/- 0.5 micrograms/mg; P 0.001). These differences were unchanged at six days but were not statistically different at ten days. Collagenolytic activity showed no differences in the three groups during the study. It is concluded that flurbiprofen enhances colonic healing with improved collagen synthesis without affecting collagenolytic activity.

Animals↗
PubMed1984

Leakage of low rectal anastomosis. An anatomic explanation?

Anastomotic leakage is particularly common in low anterior resection. This may be due to poor blood supply of the cut ends. Eighteen angiograms of the rectum were studied and a midline paucity of vessels was found both anteriorly and posteriorly. This may provide an anatomic explanation for dehiscence.

Adult↗
PubMed1984

Prevention of bacterial colonization of wounds at operation: comparison of iodine-impregnated ('Ioban') drapes with conventional methods.

Forty-five patients undergoing clean elective inguinal surgery were randomly allocated to receive one of three skin preparations, (1) alcoholic povidone-iodine ('Betadine') alone, (2) the same covered with an incise drape ('Steri-Drape'), or (3) an iodine-containing incise drape ('Ioban') alone. The first two preparations were superior in reducing bacterial colony counts measured on skin with cotton swabs and impression cultures. There were no clinical postoperative wound infections in any group but it is suggested that although the use of an iodine-containing incise drape alone is attractive, its bactericidal action is inferior to conventional preparations.

Disinfection↗
PubMed1984

Experimental infection and hydrogel dressings.

The prolonged use of a hydrogel (polyacrylamide) dressing on circular 1 cm skin defects was tested in a rat experimental model. The rate of healing and changes in bacterial content following inoculation of 1 X 10(8) Staphylococcus aureus, Escherichia coli or Pseudomonas aeruginosa were measured. Wounds inoculated with Staph. aureus or E. coli prior to polyacrylamide occlusion did not have delayed wound contraction and healing and numbers of organisms were falling at 10 days. Wounds inoculated with Ps. aeruginosa showed a delay in healing with a large increase in organisms (greater than 1 X 10(10] after 10 days occlusion. Prolonged wound occlusion by hydrogel dressings may aid in healing by secondary intention but the presence or growth of pseudomonas indicates that frequent changes of dressings should be made.

Animals↗
PubMed1984

A study of microangioneogenesis in wounds healing by secondary intention.

A method is described for the study of microangioneogenesis in wounds healing by secondary intention. Standard skin defects were created on the backs of Sprague-Dawley rats and angiograms of the new vessels in the healing wounds were performed at subsequent time intervals. The technique allowed comparison of the rate of new vessel formation in wounds covered with a hydrogel surgical dressing with those healing without a dressing. It was found that the rate of new capillary formation was faster in the covered wounds.

Animals↗