Karın Ön Duvar Defektlerinin Kapatılmasında Prolen Mesh Ve Strech Film Kullanımının Yapışıklık Üzerine Etkisi: Deneysel Çalışma
Küçük Resim Yok
Tarih
2012
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kocaeli Derince Eğitim ve Araştırma Hastanesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Karın ameliyatları sonrası barsak yapışıklıkları ciddi morbidite ve mortaliteye neden olmaktadır. Çalışmamızda insizyonel hernilerde defektin kapatılmasında kullanılan primer kapama, Poliprolen mesh, Prolen mesh - strech filmin adhezyon etkileri karşılaştırıldı. Gereç ve Yöntem: Çalışmada 10 aylık 250–300 gram beyaz Wistar Albina cinsi 30 adet sıçan kullanıldı. Grup I; Primer tamir, Grup II; Prolen mesh, Grup III; Prolen mesh - strech film kullanıldı. Denekler 20 mg/kg Ketamin Hidroklorür (Ketalar) ile uyutuldu. Karın duvarınada yarıçapı 1cm olan defekt oluşturuldu. Defekt Grup I’de primer olarak 3/0 prolen ile tek tek, Grup II’de poliprolen mesh, Grup III’te prolen mesh - strech film ile kapatıldı. Denekler 21. gün sakrifiye edildi. Yapışıklıklar Makromorfolojik ve histopatolojik olarak değerlendirildi. Bulgular: Makromorfolojik evrelendirme kriterlerine göre elde edilen yapışıklık skorları Grup I’de ortalama 1.3 ( 0-3), Grup II’de ortalama 3.4 (2-4), Grup III’de ise ortalama 0.9 (0- 2) idi. Yapışıklıklar arasındaki fark istatistiksel olarak değerlendirildiğinde Grup I ile II ve Grup II ile III arasında anlamlı fark saptandı (P<0.05). Histopatolojik incelemede Mezotel gelişimi, Vasküler proliferasyon, Kollojen oluşumu, Dev hücre oluşumu, Granülasyon oluşumu, İtihabi hücre oluşumu, ve fibroblast proliferasyonu Grup II’de en yüksek, Grup III’te ise en düşük saptandı. Sonuç: Strech film prolen mesh ile karın duvarı defektlerinde yapışıklığı önlemek amacı ile kullanılabilir, sentetik bir materyaldir.
Backround/ Aim: Postoperative adhesions may result in important serious morbidity and mortality. In this study, adhesive effects of primary closure, prolene mesh and prolene mesh-stretch films were compared in closure of incisional hernias. Material and Methods: Thirty white Wistar Albino type rats were used. They were randomized into 3 groups as following: primer repair as group I, repair with prolen mesh as group II, and repair with prolen mesh-stretch film as group III. Rats were anaesthesized with ketamin hydroclorur. An artificial defect with 1 cm diameter was formed on abdominal wall. It was repaired with 3/0 prolene in group I, with prolene mesh in group II and with prolen mesh-stretch film in group III. Rats were sacrificed on 21st day. Histopatholocical and macromorphological staging criteria, proposed by Mazuji et al, were evaluated. Results: Mean adhesive scores according to macromorphological stating were 1.3 (0-3) in group I, 3.4 (2-4) in group II, and 0.9 (0-2) in group III. Adhesiveness was statistically different betweeen group I-II, and group II-III (p<0.05). Histopathologic examination revealed scores for group I, II and III consecutively as mesotelial growth of 0.7, 1.9, 0.5, vascular proliferation of 1.7, 2.8, 0.7, collagen formation of 1.5, 2.8, 0.8, giant cell formation of 1.1, 2.3, 0.4, granulation of 0.3, 1.9, 0.3, inflammatuary reaction of 1.7, 3.0, 0.7, and fibroblast proliferation of 1.7, 2.8, 0.7. Conclusion: Prolen mesh - strectch film is a cheap and suitable synthetic material which can be used to prevent adhesions when repair of abdominal wall defects is considered.
Backround/ Aim: Postoperative adhesions may result in important serious morbidity and mortality. In this study, adhesive effects of primary closure, prolene mesh and prolene mesh-stretch films were compared in closure of incisional hernias. Material and Methods: Thirty white Wistar Albino type rats were used. They were randomized into 3 groups as following: primer repair as group I, repair with prolen mesh as group II, and repair with prolen mesh-stretch film as group III. Rats were anaesthesized with ketamin hydroclorur. An artificial defect with 1 cm diameter was formed on abdominal wall. It was repaired with 3/0 prolene in group I, with prolene mesh in group II and with prolen mesh-stretch film in group III. Rats were sacrificed on 21st day. Histopatholocical and macromorphological staging criteria, proposed by Mazuji et al, were evaluated. Results: Mean adhesive scores according to macromorphological stating were 1.3 (0-3) in group I, 3.4 (2-4) in group II, and 0.9 (0-2) in group III. Adhesiveness was statistically different betweeen group I-II, and group II-III (p<0.05). Histopathologic examination revealed scores for group I, II and III consecutively as mesotelial growth of 0.7, 1.9, 0.5, vascular proliferation of 1.7, 2.8, 0.7, collagen formation of 1.5, 2.8, 0.8, giant cell formation of 1.1, 2.3, 0.4, granulation of 0.3, 1.9, 0.3, inflammatuary reaction of 1.7, 3.0, 0.7, and fibroblast proliferation of 1.7, 2.8, 0.7. Conclusion: Prolen mesh - strectch film is a cheap and suitable synthetic material which can be used to prevent adhesions when repair of abdominal wall defects is considered.
Açıklama
Anahtar Kelimeler
Karın duvarı defektleri|barsak yapışıklığı|strech film|Abdominal wall defect|adhesion|strech film
Kaynak
Kocaeli Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
1
Sayı
1
