Sıçanlarda flepte oluşan iskemi-reperfüzyon hasarında sülük ve ozon uygulmasının etkilerinin araştırılması
Küçük Resim Yok
Tarih
2020
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Vücutta oluşan bir doku eksikliğinde o bölgesinin rekonstrüksiyonunda flep cerrahisi sıklıkla kullanılmaktadır. Flep cerrahisindeki en büyük sorun flebin iskemiye uğraması ve sonrasında reperfüzyon ile oluşan serbest oksijen radikallerinin flep sağ kalımını azaltması ve flebin kısmi ve ya tam nekrozuna neden olmasıdır. Bu çalışmamızda, ozon terapisi ve hirudoterapinin, flep cerrahisinde oluşan iskemi reperfüzyon (İ/R) hasarında flep nekrozuna neden olan serbest oksijen radikalleri üzerine etkilerini araştırmak amaçlanmıştır. Gereç ve Yöntem: Çalışmamızda ağırlıkları 200-250gr arasında değişen Wistar Albino cinsi dişi sıçan kullanıldı. Gruplar 5 eşit gruba ayırıldı. Sham grubu (A grubu) dahil her gruba standart sakral arter bazlı dorsal flep uygulandı. Kontrol grubunda (B grubu) sakral arterler klemplenerek I/R hasarı oluşturuldu. Tıbbi steril sülük + flep grubuna (C grubu), I/R hasarı yapılan flebe postoperatif 5. dakika ve 8. saatte olmak üzere her uygulamada eş zamanlı flebin distaline ve proksimaline sülük uygulandı. Flep + tıbbi ozon uygulanan gruba (D grubu) I/R hasarı yapılan flebe postoperatif 5. dakikadan başlamak üzere yedi gün boyunca günlük olarak intraperitoneal (i.p.) tıbbi ozon uygulaması yapıldı. Flep + tıbbi steril sülük + tıbbi ozon grubuna (E grubu), I/R hasarı yapılan flebe C grubundaki gibi tıbbi steril sülük ve D grubuyla aynı şekilde tıbbi ozon uygulaması diğer grupla aynı olacak şekilde uygulandı. Postoperatif yedinci günde sıçanlardan kan ve doku alınarak biyokimyasal ve histopatolojik değerlendirmeleri ve digital fotoğraflanarak flep nekroz alan ölçümleri yapıldı. Bulgular: Beş grubun serum biyokimyasal değerleri, doku antioksidan ve oksidan parametreleri ve alan hesapları karşılaştırıldı. Kollajen yoğunluğu, fibroblast maturasyonu, damar yoğunluğu açısından anlamlı farklar bulundu. Ayrıca, SOD, GSH ve MDA değerleri açısından gruplar arasında anlamlı farklar vardır. Ayrıca serumdan çalışılan WBC, HB, AST, LDH, BUN ve kreatinin değerlerinde de gruplar arasında anlamlı farklar bulunmuştur. Sonuçlar: Yaptığımız bu çalışmamızda, flep cerrahisi sonrasında gelişen İ/R hasarında tıbbi steril sülük ve ozon terapisi uygulaması ile flep yaşaya bilirliğini arttırılabileceğini, yara iyileşmesinde olumlu etkilerinin olduğunu ve ayrıca diğer organlar üzerine olan etkilerinin sinerjistik etkileri ile daha da fazla olumlu yönde olduğunu gösterdik.
Aim: In the absence of any tissue in the body, flap surgery is frequently used in the reconstruction of that area. The most important problem in flap surgery is that ischemia in the flep and then free oxygen radicals formed by reperfusion, decrease flap survival and cause partial or complete necrosis of flap. In this study, we aimed to investigate the effects of medical ozone therapy and hirudotherapy on flap necrosıs because of free oxygen radicals that caused by ischemi-reperfusion(I/R) injury in flap surgery. Materials and Methods: In our study, Wistar Albino female rats weighing between 200-250g were used. The groups were divided into 5 equal groups. A standard sacral artery-based dorsal flap was applied to each group, including the sham group (group A). I/R injury was created by clamping the sacral arteries in the control group (group B). In the medical sterile leech + flap group (group C), leech was applied to the distal and proximal of the flap simultaneously in each application, at the postoperative 5th minute and 8th hour. Intraperitoneal (i.p.) medical ozone was applied daily to the flap + medical ozone-treated group (group D) for seven days, starting from the 5th minute postoperatively to the flap where I/R damage was performed. Medical ozone application was applied to the flap + medical sterile leech + medical ozone group (E group) in the same manner as medical C sterile leech and D group in the same way as the C group. On the seventh postoperative day, biochemical and histopathological evaluations were taken from the rats and flap necrosis measurements were performed by digital photographs. Results: Serum biochemical values, tissue antioxidant and oxidant parameters and area calculations of five groups were compared. There were significant differences in terms of collagen density, fibroblast maturation and vascular density. In addition, there are significant differences between the groups in terms of SOD, GSH and MDA values. In addition, significant differences were found between the groups in serum WBC, HB, AST, LDH, BUN and creatinine values. Conclusions: In this study, we showed that flap viability can be increased with medical sterile leech and ozone therapy application in the I / R damage that develops after flap surgery, and it has positive effects on wound healing, and its effects on other organs are even more positive with synergistic effects.
Aim: In the absence of any tissue in the body, flap surgery is frequently used in the reconstruction of that area. The most important problem in flap surgery is that ischemia in the flep and then free oxygen radicals formed by reperfusion, decrease flap survival and cause partial or complete necrosis of flap. In this study, we aimed to investigate the effects of medical ozone therapy and hirudotherapy on flap necrosıs because of free oxygen radicals that caused by ischemi-reperfusion(I/R) injury in flap surgery. Materials and Methods: In our study, Wistar Albino female rats weighing between 200-250g were used. The groups were divided into 5 equal groups. A standard sacral artery-based dorsal flap was applied to each group, including the sham group (group A). I/R injury was created by clamping the sacral arteries in the control group (group B). In the medical sterile leech + flap group (group C), leech was applied to the distal and proximal of the flap simultaneously in each application, at the postoperative 5th minute and 8th hour. Intraperitoneal (i.p.) medical ozone was applied daily to the flap + medical ozone-treated group (group D) for seven days, starting from the 5th minute postoperatively to the flap where I/R damage was performed. Medical ozone application was applied to the flap + medical sterile leech + medical ozone group (E group) in the same manner as medical C sterile leech and D group in the same way as the C group. On the seventh postoperative day, biochemical and histopathological evaluations were taken from the rats and flap necrosis measurements were performed by digital photographs. Results: Serum biochemical values, tissue antioxidant and oxidant parameters and area calculations of five groups were compared. There were significant differences in terms of collagen density, fibroblast maturation and vascular density. In addition, there are significant differences between the groups in terms of SOD, GSH and MDA values. In addition, significant differences were found between the groups in serum WBC, HB, AST, LDH, BUN and creatinine values. Conclusions: In this study, we showed that flap viability can be increased with medical sterile leech and ozone therapy application in the I / R damage that develops after flap surgery, and it has positive effects on wound healing, and its effects on other organs are even more positive with synergistic effects.
Açıklama
Anahtar Kelimeler
Plastik ve Rekonstrüktif Cerrahi, Plastic and Reconstructive Surgery