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AMELİYAT SONRASI KARIN İÇİ YAPIŞIKLIKLARIN ÖNLENMESİNDE CHITIN'İN ETKİNLİĞİNİN DİĞER ADEZYON BARİYERLERİ İLE KARŞILAŞTIRILMASI

COMPARISON OF ANTI-ADHESION MATERIALS IN PREVENTING POSTSURGICAL ADHE¬SION IN ABDOMINAL CAVITY

Journal Name:

  • Selçuk Tıp Dergisi

Publication Year:

  • 2007

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Abstract (2. Language): 
Aim: The purpose of this study is to compare the effects of different anti-adhesion Materials in Preventing Postsurgical peritoneal adhesion. Material and Method: 60 rats from Wistar Albino spiece that weights 250-300 g and about 10-11 ages are used in the study. They were separated into 5 groups. The rats were operated after Kethamine HCL anesthesia. In all rats, a midline laparatomy was done, in a 4 cm length. To the right side of the abdominal wall, 2 cm along 10 par-ellel incision were applied. To the left side of it, a peritoneum layer was incised as 2x2 cm2. The abdominal wall was sutured with 3/0 silk by continue method. Group I: Control group, Group II: 3X3 cm2 in size Chitin layers (Suprofilm®) were placed on the incision areas. Group III: 3X3 cm2 in size Na-Hyaluronat / Carboxymethylcellulose layers (Seprafilm®) were placed on the incision areas. Group IV: To the abdominal cavity, 25 % diluted 2 cc Na-Hyaluronat gel was poured, Group V: 15mg/kg metilprednizolon was injected as I.M. On the 11th day of Research, under Ketamine anes¬thesia, abdominal wall opened and the adhesions were scored according to Granat Score. From all groups of rats, blood samples were taken. On the samples, Hb, AST, BUN and Albumin levels were studied. Results: The Adhesion frequency In Group I, was defined on the right abdominal wall as 82%, on the left as 91%, In Group II, on the right as 8.3%, on the left as 25%, In Group III, on the right as 17%, on the left as 33%, In Group IV, on the right as 50%, on the left as 58%, In Group V, on the right as 50%, on the left as 42%. The adhesion grade in groups was defined as; Group I: 2.63±1.22, Group II: 0.58±0.66, Group III: 1.08±1.08, Group IV: 1.41±1.44, Group V: 1.41±1.50. The adhesion phase in all study groups was found meaningfully low compared to the control group as p<0.05. Besides, the adhesion grade of Suprofilm® group was found meaningfully low com¬pared to the other groups as p<0.05. A meaningful difference was not observed among Serologic and hematological parameters in all groups as P>0.05. Conclusion: Chitin meaningfully decreases the postoperative peritoneal adhesion frequency and adhesion grade on Rats. Referencing this result, it has been understood that Chitin is much more effective than local and systemic anti-adhe¬sive methods.
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Abstract (Original Language): 
Amaç: Postoperatif peritoneal adezyonların önlenmesinde farklı antiadeziv maddelerin etkilerinin belirlenmesidir. Gereç ve Yöntem: Çalışmaya 60 adet Sprague-Dawley cinsi dişi rat alındı. Ratlar '2'şerli 5 gruba ayrıldılar. Bütün ratlar Ketamine HCL ile uyutulduktan sonra 4 cm'lik orta hat kesisi ile karına girildi. Karın duvarında, sağ tarafta 2cm uzunluğunda '0 adet peritoneal kesi yapıldı, sol tarafta 2X2 cm2 genişliğinde periton tabakası eksize edildi, batın 3/0 ipekle kontinu olarak kapatıldı. Grup I: herhangi bir işlem yapılmadı, Grup II: kesi alanlarına 3X3 cm2 boyutta chitin tabakası (Suprofilm®) konuldu, Grup III: kesi alanlarına 3X3 cm2 boyutta Na-Hyaluronat / Carboxymethylcellulose (Seprafilm®) konuldu, Grup IV: batın içine % 25 oranında sulandırılmış 2 cc Na-Hyaluronat jel döküldü, Grup V: '5mg/kg dozunda metilprednizolon i.m. olarak verildi. Çalışmanın 11. günü ratlar sacrifiye edilerek 5'er cc kan alındı. Batın açılarak adezyonlar Granat Skoruna göre skorlandı. Kan örneklerinden Hb, AST, BUN ve Albumin düzeyleri çalışıldı. Bulgular: Adezyon sıklığı Grup I'de sağda %82, solda % 9', Grup II'de sağda %8.3, solda %25, Grup III'te, sağda %'7, solda %33, Grup IV'te sağda %50, solda %58, Grup V'te sağda %50, solda %42 olarak bulundu. Adezyon evresi gruplarda; Grup I: 2.63±'.22, Grup II: 0.58±0.66, Grup III: '.08±'.08, Grup IV: '.4'±'.44, Grup V: '.4'±'.50 olarak belirlendi. Adezyon evresi tüm çalışma gruplarında kontrol grubuna göre anlamlı olarak düşük bulundu, p<0.05. Ayrıca Chitin grubunun evresi diğer gruplardan anlamlı olarak düşük bulundu, p<0.05. Serolojik ve hematolojik parametreler tüm gru¬plarda benzer bulundu, P>0.05. Sonuç: Chitin Ratlarda postoperatif peritoneal adezyon sıklığını ve evresini anlamlı olarak düşürmekterdir. Bu yönüyle lokal ve sistemik antiadezivlerden daha etkili olduğu kanaatine varılmıştır.
FULL TEXT (PDF): 
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  • 4
189-195
  • Turkish

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