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| | Section 5 Chapter 29 Intestinal Anastomosis |
 | | One study that examined the relative efficiency of absorbable and nonabsorbable material concluded that the strength of the anastomosis, expressed as a percentage of normal tissue strength, was essentially the same regardless of the type of suture used. |
 | | Initially, tissue eversion at the stapled anastomosis was a major concern, given that everted hand-sewn anastomoses had previously been shown to be inferior to inverted ones; however, the greater support and improved blood supply to the healing tissues associated with stapling tend to counteract the negative effects of eversion. |
 | | Even when the anastomosis had to heal under adverse conditions (e.g., carcinomatosis, malnutrition, previous chemotherapy or radiation therapy, bowel obstruction, anemia, or leukopenia), no significant differences were apparent between stapled and hand-sewn anastomoses. |
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