The application of a new type of intestinal diversion devices in Beagle dogs with intestinal transection injury and hemorrhagic shock.

OBJECTIVE

This study evaluated the efficacy and safety of a series of prototype intestinal diversion devices in a Beagle hemorrhagic shock model comprising four complex bowel-injury patterns (small and large bowel).

METHODS

Sixteen Beagle dogs were randomized to four intestinal injury models (n = 4 each): (1) single-site small bowel transection, (2) suspected long-segment small-bowel ischemia/necrosis, (3) two-site small bowel transection, and (4) combined small-bowel injury with colon rupture. Within each cohort, animals were allocated to either conventional suture ligation of the bowel ends (bowel left in discontinuity) or device-mediated diversion to temporarily restore luminal continuity. Systemic inflammation (blood pH, endotoxin, TNF-α, IL-6, IL-10) was monitored at baseline and 2, 4, 8, and 24 h postoperatively. On postoperative day 30, tissue samples from the intestinal stump were excised to evaluate morphological changes and the extent of inflammatory infiltration via light microscopy.

RESULTS

Baseline characteristics were comparable between groups, and all animals (16/16) survived to day 30. Postoperatively, endotoxin, TNF-α, and IL-6 increased in both groups but were markedly attenuated in the diversion group. IL-10 showed a higher increase in the diversion group. The length of necrotic bowel requiring resection was consistently shorter with diversion. On postoperative day 30, histology showed well-perfused anastomoses with mild inflammation in the diversion group, whereas the ligation group exhibited ischemic necrosis with severe transmural inflammation.

CONCLUSION

Preliminary findings suggest that the new intestinal diversion devices represent a feasible and promising strategy for damage control in complex intestinal trauma, particularly in the setting of combined injuries and hemorrhagic shock.