Kadri ÖZER, Özlem ÇOLAK, Yüksel KANKAYA, Uğur KOÇER, Melike ORUÇ, Koray GÜRSOY, Veysel Murat IŞIK

DENEYSEL İSKEMİ REPERFÜZYON MODELİNDE ASİMETRİK DİMETİL ARJİNİN SEVİYESİNİN FLEP YAŞAMI ÜZERİNDE TANI KOYDURUCU DEĞERİ

AMAÇ: Endojen bir nitrik oksit sentetaz inhibitor molekülü olan ‘asimetrik di-metil arjinin’ ADMA konsantrasyonu belli spesifik durumlarda artmaktadır. ADMA’nın sistemik üretimi iskemi reperfüzyon hasarına uğramış hayvanlarda daha fazladır. Bunun yanında nitrik oksit ve nitric oksit sentetaz, deri fleplerinin sağ kalımında oldukça önemlidir. Bu çalışmanın amacı da artmış ADMA seviyesi ve deri flep yaşayabilirliği arasındaki muhtemel ilişkinin deneysel olarak incelenmesidir. GEREÇ VE YÖNTEMLER: Çalışmada 26 adet erişkin Wistar sıçan kullanıldı. Grup 1’de abdominal flepler kaldırıldı ve tekrar yerine dikildi. Grup 2’de ise süperfisyal epigastrik damarlar bazlı abdominal aksiyel flepler eleve edildi ve sonrasında vasküler pedikül klemplenerek 8 saatlik sıcak iskemi periyodu oluşturuldu. Plazma ADMA seviyeleri preoperatif ve reperfüzyon sonrası 4. saatte ölçüldü. BULGULAR: Grup 1 ve grup 2’de ortalama preoperatif ADMA seviyeleri 0,283 ve 0,301 olarak hesaplandı. Postoperatif ADMA seviyeleri ise sırasıyla 0,296 ve 0,471 µmol/l olarak bulundu. Postoperatif 10.günde, ortalama flep nekroz alanı grup 1’de 2.6 %± 3.0 ve grup 2’de 44.4% ± 10.7 olarak hesaplandı. Preoperatif ADMA seviyeleri arasındaki fark istatistiksel olarak anlamlı değildi p>0.05 fakat postoperatif ADMA seviyeleri grup 2’de istatistiksel olarak anlamlı derecede yüksekti p

Anahtar Kelimeler:

İskemi reperfüzyon, flep, sağ kalım, asimetrik dimetil arjinin

DIAGNOSTIC VALUE OF ASYMMETRIC DI-METHYL ARGININE LEVEL FOR FLAP SURVIVAL IN EXPERIMENTAL ISCHEMIA REPERFUSION MODEL

OBJECTIVE: Nitric oxide is important for skin flap survival. Systemic production of endogenous nitric oxide synthase inhibitor molecule ‘asymmetric di-methyl arginine’ ADMA is greater in animals having ischemia reperfusion injury. Aim of this study was to evaluate possible correlation of elevated levels of ADMA with skin flap survival in an experimental model.MATERIAL AND METHODS: I26 adult Wistar rats were used in study. In group I abdominal flaps were elevated and sutured back. Abdominal axial flaps were elevated and subsequent 8 hours of warm ischemia period was created in group II. Plasma ADMA levels were calculated preoperatively and after 4 hours of reperfusion. RESULTS: Mean preoperative ADMA levels were calculated as 0,283 and 0,301 µmol/l in group 1 and group 2. Postoperative ADMA levels were 0,296 and 0,471 µmol/l respectively. At postoperative 10th day, mean area of flep necrosis were found to be as 2.6 %± 3.0 and 44.4% ± 10.7 in group 1 and group 2. Differences between preoperative ADMA levels were not statistically significant p>0.05 but postoperative ADMA levels were significantly higher in group II p

Keywords:

Ischemia, reperfusion injury, surgical flap, asymmetric dimethyl arginine,

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