The Role of a Combination of Autogenous Fresh Bone Marrow and Omental Free Graft in the Cervical Esophageal Wound Healing in Dogs

Abstract

Problem statement: Esophageal surgery is associated with greater wound healing problems than surgery on other portion of the alimentary tract. Omentum and fresh bone marrow are rich source of angiogenic factors that promote the growth of blood vessels into wound tissue. The aim of this study was evaluation of the effects of a combination of autogenous fresh bone marrow and omental free graft in esophageal wound healing. Approach: This study was carried out on 8 male adult dogs, assigned into two equal treatment and control groups. All dogs underwent cervical esophagotomy and laparotomy operations, also bone marrow aspiratin, simultaneously. A 3 cm linear full thickness incision was made on the cervical esophagus and then sutured. In treatment group, A small piece of omentum was obtained from abdominal cavity and secured on esophageal suture line and then 1 mL of fresh bone marrow was injected into the omental graft and wound edge. In the control group, the suture line was left without any treatment and the harvested omentum and aspirated bone marrow were disposed. During this study, the dogs were examined clinically and they were euthanized 14 days after operation. The surgical site of esophagus was assessed macroscopically and then histopathologic samples were taken from the repaired tissue of esophageal wall. The samples were stained by hematoxylin-eosin and masson-trichorome. Results: The clinical evaluation of present study revealed that all dogs were healthy with no major postoperative complications. There was no significant difference based on macroscopic examination in surgical site of esophagus between the two groups. The microscopic study revealed that inflammatory cells, angiogenesis and granulation tissue formation in wound bed of the treatment group were significantly more than the control group. Conclusion: According to the results of this study, application of a combination of autogenously fresh bone marrow and free omental graft can improve wound healing process in esophageal incision wounds.