Erişkin hastalarda hyaluronik asit deri eşdeğeri kullanım sonuçlarının klinik ve histopatolojik olarak değerlendirilmesi
Küçük Resim Yok
Tarih
2012
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İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Amaç:Ocak 2011-mart 2012 döneminde İnönü Üniversitesi Tıp Fakültesi Plastik Rekonstrüktif ve Estetik Cerrahi kliniğinde tedavisinde hyaluronik asit deri eşdeğeri kullanılan hastaların klinik ve histolojik sonuçları değerlendirilmiştir.Materyal ve metod:Hastalar 2 gruba ayrıldı. 1.gruptaki HS veya K'li 10 hastanın tedavisinde HA deri eşdeğeri kullanıldı. Bu grup hastalarda peroperatif ve 3. ayda postoperatif deri biopsileri alınarak histopatolojik incelemeye tabi tutuldu. 2.grupta travma, yanık veya eksizyonel nedenlerle tam kat doku kaybı olan 7 hastada HA tedavisi uygulandı. Her iki grubtada skar kalitesi vankover skar skalası ile değerlendirildi.Bulgular:Grup 1 deki hastaların yaşları ortalama 25.2±10.2 yıl ve takip süreleri 9.6±3.6 ay34olmuştur. Grup 2 de ise 26.4±8 yıl ve takip süreleri 6.7±3.2 ay olmuştur. Grup 1 deki hastaların VSS skorları preop 10.7±1.16 ve postop 6.2±0.91 olarak saptanmıştır. Bu fark istatistiksel olarak anlamlı bulunmuştur (p?0,005).Grup 2 de hiçbir hastada takip süreci sırasında HS veya K gelişimine rastlanmamıştır. Grup 1 de alınan deri biopsilerinde kollejanizasyon parametresi açısından preop değerler postop değerlerden anlamlı olarak yüksek bulunmuş (p?0,001) iken vaskülarizasyon parametresi yönünden preop değerler postop değerlerden anlamlı derecede düşük bulunmuştur (p?0,0001).Sonuç:HA deri eşdeğeri kullanımı erişkin hastaların HS veya K tedavisinde 6 aylık takiplerde istenen klinik iyileşmeyi sağlamaktadır. Aynı zamanda erişkin hastalarda diğer tedavi seçeneklerine bir alternatif olarak tam kat doku kayıplarında HA uygulaması dayanıklı bir deri örtüsünü sağlayabilmektedir.
Objective:Clinical and histopathological results of the hyaluronic acid skin substitute treatment of the patients who admitted to Inonu University Medical Faculty Plastic Reconstructive and Aesthetic Surgery clinic between january 2011 and march 2012 were evaluated.Materials and methods:The patients were divided into two groups. HA were used for treatment of H or K in 10 patients of the first group. Skin biopsies obtained at peroperative and postoperative 3rd month were subjected to histopathologic examination in this group. In the second group 7 patients with full thickness soft tissue loss secondary to burns, trauma or excisional reasons were also treated with HA application. Vancouver scar scale were used to determine the scar quality in both groups.36Results:Mean age was 25.2±10.2 and mean follow-up duration was 9.6±3.6 months in group 1. Mean age was 26,4±8 and mean follow-up duration was 6,7±3,2 months in group 2. Preop and postop VSS scores in group 1 were 10.7±1.16 and 6.2±0.91 respectively. This difference was statistically significant (p?0,005). No HS or K development was seen in any patient in group 2 during the following period. Collagenisation scores of preop biopsies were significantly higher than postop scores (p?0,0001).Vascularisation scores of preop biopsies were significantly lower than postop scores (p?0,00001).Conclusion:The use of HA skin substitute in adults for treatment of HS or K provides the desired clinical healing in the 6 months follow-up periods. At the same time, HA application as an alternative to other treatment modalities leads to a durable skin coverage.
Objective:Clinical and histopathological results of the hyaluronic acid skin substitute treatment of the patients who admitted to Inonu University Medical Faculty Plastic Reconstructive and Aesthetic Surgery clinic between january 2011 and march 2012 were evaluated.Materials and methods:The patients were divided into two groups. HA were used for treatment of H or K in 10 patients of the first group. Skin biopsies obtained at peroperative and postoperative 3rd month were subjected to histopathologic examination in this group. In the second group 7 patients with full thickness soft tissue loss secondary to burns, trauma or excisional reasons were also treated with HA application. Vancouver scar scale were used to determine the scar quality in both groups.36Results:Mean age was 25.2±10.2 and mean follow-up duration was 9.6±3.6 months in group 1. Mean age was 26,4±8 and mean follow-up duration was 6,7±3,2 months in group 2. Preop and postop VSS scores in group 1 were 10.7±1.16 and 6.2±0.91 respectively. This difference was statistically significant (p?0,005). No HS or K development was seen in any patient in group 2 during the following period. Collagenisation scores of preop biopsies were significantly higher than postop scores (p?0,0001).Vascularisation scores of preop biopsies were significantly lower than postop scores (p?0,00001).Conclusion:The use of HA skin substitute in adults for treatment of HS or K provides the desired clinical healing in the 6 months follow-up periods. At the same time, HA application as an alternative to other treatment modalities leads to a durable skin coverage.
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ERBATUR, S. (2012). Erişkin hastalarda hyaluronik asit deri eşdeğeri kullanım sonuçlarının klinik ve histopatolojik olarak değerlendirilmesi, İnönü Üniversitesi / Tıp Fakültesi / Plastik ve Rekonstrüktif Cerrahi Ana Bilim Dalı.
