Levent ERALP, Mehmet KOCAOĞLU, Ata Can ATALAR, Şamil AKTAŞ, Salih AYDIN, Okan SOYHAN, Maktav DİNÇER, Vakur OLGAÇ, Rian DİŞÇİ

Hiperbarik oksijen uygulamasının sıçanlarda irradiye otojen kemik grefti üzerine etkisi: Deneysel çalışma

Amaç: Radikal radyoterapinin kullanımı, yol açtığı doku hasarı nedeniyle kısıtlıdır. Ek hiperbarik oksijen tedavisi potansiyel olarak radyasyonun yarattığı devaskülarizasyon sürecini engelleyebilir ve biyolojik rekonstrüksiyon modellerinin dezavantajlarını ortadan kaldırabilir. Bu çalışmada radyasyonun ve hiperbarik oksijen uygulamasının kemik iyileşmesi üzerine etkileri araştırıldı. Çalışma planı: Yüz yirmi adet Wistar cinsi sıçan rastgele dört gruba ayrıldı. Kontrol grubunda, tibia diafizinden çıkartılan segment tekrar implante edildi. İkinci gruptaki sıçanlara, rezeksiyon ve reimplantasyondan sonra hiperbarik oksijen tedavisi uygulandı. Üçüncü gruba ait diafizer kemik segmentleri tekrar implante edilmeden önce irradiye edildi. Dördüncü grupta ise irradiye segmentler tekrar implante edildikten sonra, deneklere ek olarak hiperbarik oksijen tedavisi uygulandı. Sonuçlar: Hiperbarik oksijen tedavisi konvansiyonel otogreftlerin kemik iyileşmesini altıncı haftanın sonunda anlamlı derecede artırdı. Tek fraksiyonda uygulanan tümörisidal dozda radyasyon, kemik iyileşmesini kronik fazda engelledi. On ikinci haftanın sonunda, histolojik ve radyolojik bulgular, dördüncü grup örneklerinde üçüncü gruba göre anlamlı derecede daha iyi kemik iyileşmesi ortaya koydu. Çıkarımlar: Hiperbarik oksijen tedavisi, radyasyonun kemik iyileşmesi üzerindeki kötü etkilerini engelleyebilir ve habis kemik tümör cerrahisinde rezeksiyonu takiben, tümörlü segmentin irradiye edilip tekrar implante edilmesi ile yapılan biyolojik rekonstrüksiyonlarda yararlı olabilir.

Anahtar Kelimeler:

Hayvan deneyleri, Sıçanlar, Kemik yenilenmesi, Kemik gelişimi, Kemik nakli, Tibia, Hiperbarik oksijenleme, Kemik ve kemikler, Yara iyileşmesi, Radyasyon etkileri, Osteoradyonekroz

Impact of hyperbaric oxygen therapy on irradiated autogenous bone grafts in rats

Objectives: Limited tissue tolerance precludes the use of radical radiotherapy. Adjuvant hyperbaric oxygen therapy potentially can revert the devascularization process in radiation-induced injuries and eliminate the disadvantages of biologic reconstruction methods. The aim of this experimental study is to evaluate the effects of irradiation and hyperbaric oxygen therapy on bone healing. Methods: One hundred-twenty Wistar rats were randomly allocated into four groups. A tibial diaphyseal segment was resected and reimplanted in one group as controls. Rats in the second group received adjuvant hyperbaric oxygen therapy following resection and reimplantation. In the third group, reimplantation was performed following irradation of bone segments. The fourth group was treated with adjuvant hyperbaric oxygen therapy after reimplantation of an irradiated bone segment. Results: Hyperbaric oxygen therapy significantly increased healing of conventional bone autografts after six weeks. Tumoricidal irradiation administered at a single fraction caused marked impairment in bone healing at the chronic phase. Histologic and radiologic findings after 12 weeks revealed substantial improvement in bone healing in the fourth group in comparison to the third group. Conclusion: Hyperbaric oxygen therapy may have a relevant role in eliminating deleterious effects of irradiation on the biologic potential of bone tissue and may be used as an adjunct for bone segments resected and irradiated to be used in biological reconstruction.

Keywords:

Animal Experimentation, Rats, Bone Regeneration, Bone Development, Bone Transplantation, Tibia, Hyperbaric Oxygenation, Bone and Bones, Wound Healing, Radiation Effects, Osteoradionecrosis,

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