Arif Hakan DEMİREL, Kazım Çağlar ÖZÇELİK

İntraperitoneal Polipropilen Mesh Kullanımına Bağlı Adezyonların Proflaksisinde Chitin Materyalinin Etkisi

Amaç: Abdominal duvar defektlerinin onarımında en sık uygulanan materyal polipropilen meshdir. Anti-adeziv bir mukopolisakkarid olan chitin maddesi ile kaplanmış polipropilen mesh ve sıvı chitinin polipropilen mesh ile indüklenen adezyon oluşumu üzerinde etkinliğinin değerlendirilmesi amaçlandı. Gereç ve yöntem: Otuz erkek Wistar Albino rat randomize 3 gruba ayrıldı. Abdominal defekt sadece polipropilen mesh ile kapatılanlar A grubunu, polipropilen mesh ile birlikte sıvı chitin uygulananlar B grubunu ve polipropilen meshin batın ile temas eden iç yüzeyine bariyer şekilde film chintin uygulananlar C grubunu oluşturdu. Gruplar arasında polipropilen meshin fasyadan ayrılıp, yer ve şekil değiştirmesi ve materyal ile abdominal yapılar arasında yabancı cisim granülomları, materyalin kopma basınçları ve diğer morbiditeler gözlendi ve değerlendirildi. Bulgular: Tüm gruplarda omentum ile adezyon mevcuttu. A grubunda 7 olguda karaciğer ve 3 olguda ince bağırsak adezyonu saptandı. Adezyonların kalınlığı ortalama 19.25 mm, kopma basıncı 2.57 kg olarak ölçüldü. B grubunda tüm olgularda ince bağırsak ve karaciğer adezyonu ayrıca 2 olguda mesane ile adezyon saptandı. Adezyonların kalınlığı ortalama 37,52 mm, kopma basıncı 2.42 kg olarak ölçüldü. C grubu, B grubuna benzer şekilde tüm olgularda ince bağırsak ve karaciğer adezyonu vardır. Ayrıca 4 olguda mesane, bir olguda pankreas diğer bir olguda ise kalın bağırsakta adezyon mevcuttu. Adezyonların kalınlığı ortalama 46,14 mm, kopma basıncı 1.97 kg olarak ölçüldü. Gruplar arasında adezyon sayısı ve adezyon kalınlığı A grubuna göre B ve C gruplarında istatiksel olarak anlamlı şekilde daha fazla izlendi p

The Effect of Chitin Material On Prophylaxis of Adhesions Due To Intraperitoneal Polypropylene Mesh

Purpose/Aim: Polypropylene mesh is the most applied and used material in the repairing of the abdominal wall. The purpose of this study is the evaluation of the efficiency of chitin, an anti-adhesive mucopolysaccharide, coated polypropylene mesh and liquid chitin on the formation of adhesion induced by polypropylene mesh.Materials and Methods: Thirty male Wister Albino rats were divided into 3 groups randomly. In Group A, the abdominal defect was closed only by polypropylene mesh, in Group B, polypropylene mesh with liquid chitin was used and in Group C, chitin film was applied to the inner side of the polypropylene mesh that was attached to the abdomen. Separation of polypropylene meshes from the fascia, location and shape transformation of them, existence of foreign body granuloma between the material and abdominal structures, rupture pressure of the material and the other morbidities were observed and evaluated.Results: There was adhesion with omentum in all groups. In Group A, liver adhesion was detected in 7 cases and small intestine adhesion was detected in 3 cases. The thickness of adhesion was measured as 19.25 mm and rupture pressure was measured as 2.57 kg. In Group B, there was small intestine adhesion in all cases and bladder adhesion was detected in 2 cases. The thickness of adhesion and rupture pressure was measured on an average as 37.52 mm and 2.42 kg respectively. Similar to Group B, in Group C, there was small intestine adhesion in all cases. Moreover, there was bladder adhesion in 4 cases, pancreas adhesion in 1 case and large intestine in 1 case. The thickness of adhesion and rupture pressure was measured on average as 46,14mm and 1.97 kg respectively. The number and thickness of the adhesion were statistically much more observed in Group A according to/in comparison to Group B and C statistically p

Keywords:

Adhesion chitin, mesh,

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