Vaginal incisional wound healing in a rabbit menopause model: A histologic analysis

Intoduction and hypothesis: The vaginal wound healing process is a major determinant of surgical outcome following pelvic reconstructive surgery. Since the majority of these surgeries are performed in peri- and postmenopausal women, it is essential to understand how estrogen deficiency affects this process. We aimed to histologically evaluate the vaginal incisional wound healing process in a rabbit menopause model. Methods: Sixty three rabbits were utilized and divided into 3 groups: Twenty one underwent bilateral oophorectomy, 21 underwent a sham surgery, and 21 served as controls. Eight weeks later, standardized full-thickness 6 mm circular segments were excised from the vagina of all rabbits and spontaneous healing was recorded. Animals were euthanized sequentially, before wounding, and at 0, 4, 7, 14, 21 and 35 days after wounding, and their wounds were harvested and assessed histologically for wound healing using a validated scoring system. Results: Oophorectomized rabbits showed significantly delayed wound closure (p < 0.02), neovascularization (p < 0.01), granulation tissue accumulation and maturation (p < 0.02), collagen deposition (p < 0.01) and re-epithelialization (p < 0.01), however acute and chronic inflammation were significantly enhanced (p < 0.02). Conclusion: Oophorectomized rabbits show protracted incisional vaginal wound healing by all histologic criteria, however, inflammation is significantly enhanced.