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.