The role of collagen and bursting strength

Role of collagen:

There are three types of collagen involved in healing of the ileocolic anastomosis
These are: Type I (68%), Type III (20%) and Type V (12%)
At postoperative day 4, degradation of mature collagen is occuring
Matrix metalloproteinases are involved in this stage of collagen metabolism and could play a role in leaks
MMP-1,2 and 9 have been associated to anastomotic leak in mechanistic studies
At postoperative days 4-7, collagen synthesis overtakes collagen degradation
At postoperative weeks 5-6, there is no longer any increase in amount of collagen, but extensive ongoing turnover and synthesis of collagen

Bursting strength:

By the 4th day after surgery bursting strength reaches 60% of the bowel’s potential
By the 5-7 th day after surgery, it is equal to that of non-injured bowel (100%)