Arif Hakan DEMİREL, Berkay KÜÇÜK, Muzaffer ÇAYDERE, Salih TUNCAL, Yılmaz ÜNAL

VENTRAL HERNİ ONARIMINDA POLİPROPİLEN VE SİLİKON KAPLI POLİPROPİLEN YAMANIN RAT MODELİNDE KARŞILAŞTIRILMASI

Amaç: Bu çalışma ventral herni tamirinde polipropilen bir yama ile silikon tabaka ve silikon kaplıpolipropilen yamanın etkinliğini karşılaştırmayı amaçlamaktadır.Gereç ve Yöntem: Toplam 45 Wistar Albino rat 3 eşit gruba ayrıldı(polipropilen yama grubu, silikontabaka grubu ve silikon kaplı polipropilen yama grubu). Tüm ratlara 3 cm’lik orta hat insizyonu ya-pılarak abdominal defekt oluşturuldu. Defektler polipropilen yama, silikon tabaka ve silikon kaplıpolipropilen yama ile onarıldı. Yamalar doğrudan intraabdominal organlar üzerine yerleştirildi.Tüm ratlar postoperatif 28.günde sakrifiye edildi. İntraabdominal yapışıklıklar değerlendirildi vedokuların kopma kuvvetleri ölçüldü. Histopatolojik değerlendirme için doku örnekleri alındı.Bulgular: Silikon kaplı polipropilen yama grubunda ortalama adezyon skoru, polipropilen yamave silikon tabaka grubundaki ortalama adezyon skorundan anlamlı olarak daha düşük bulundu.Silikon tabaka grubunda yaranın histopatolojik maturasyon derecesi diğer iki gruptan anlamlı ola-rak daha düşüktü. Yama materyallerinin kopma kuvvetleri karşılaştırıldığında; polipropilen yamagrubundaki kopma kuvvetleri diğer iki gruptaki kopma kuvvetlerinden anlamlı olarak daha yüksektespit edildi.Sonuç: Ventral herni tamirinde silikon kaplı bir polipropilen yamanın kullanımı yama ve bağırsaklararasında yapışıklığa sebep olmadı ve yama ile omental yapılar arasındaki yapışıklıkları da azalttı.

Comparison of Polypropylene and Silicone-Coated Polypropylene Mesh in Repair of Ventral Hernia in a Rat Model

Objective: The aim of this study was to compare the efficacy of a silicone sheet(SS) and silicone- coated polypropylene mesh( SCPM) with a polypropylene mesh(PM) in ventral hernia repair. Materials and methods: A total of 45 Wistar Albino rats were randomly separated into 3 groups of 15(PM group, SS group and SCPM group). An abdominal defect was created in all the rats using a 3 cm midline incision. The defects were repaired with SS, PM or SCPM meshes which were placed directly over the abdominal organs. All the rats were sacrificed on postoperative day 28. The intra- abdominal adhesions were evaluated and the breaking strength of the tissues was measured. Tissue samples were taken from the mesh-fascia junction for the histopathological evaluation. Results: The mean adhesion score of the SCPM group was found to be significantly lower than that of the SS and the PM groups. The histopathological wound maturation degree in the SS group was significantly lower than that of the other two groups. Comparison of the breaking strength of the mesh materials determined significantly higher breaking strength values in the PM group compared with the other two groups. Conclusion: In the repair of ventral hernia, the use of a SCPM did not cause adhesions between the mesh and the intestines and reduced adhesions between the mesh and omental structures.

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