Dilan ALTINTAŞ URAL, Duygun ALTINTAŞ AYKAN, Muhammed SEYİTHANOĞLU, Abdulkadir Yasir BAHAR, Ali Erdal KARAKAYA, Ahmet Gökhan GÜLER

Postoperatif peritoneal adhezyonların önlenmesinde saf zeytinyağı ve PRF’nin etkinliği

Amaç: Bu çalışmada, adhezyon oluşması beklenen alanlara uygulanan trombositten zengin fibrin (PRF) ve saf zeytinyağının etkilerinin incelenmesi amaçlanmıştır. PRF’nin adezyona neden olup olmadığının ve PRF'nin batın içi operasyonlarda güvenle kullanıp kullanamayacağını araştırılmaktadır. Gereç ve Yöntem: Toplamda 4 grup (n=8) olmak üzere 40 adet Wistar albino rat çalışma gruplarında kullanıldı. Çalışma gruplarına dahil edilmeyen 8 rattan PRFeldesi için yararlanıldı. Grup 1’e herhangi bir cerrahi işlem yapılmadı. Adezyon modelin uygulandığı Grup 2’de ilaç kullanılmadı. Adezyon modeli sonrası Grup 3’de 1 cc zeytinyağı ve Grup 4’de 1 cc PRF uygulandı. 21 gün sonra çekum alanları histopatolojik olarak incelendi. Serumda proinflamatuar sitokinlerden tümör nekroz faktör-α (TNF-α), interlökin-6(IL-6), hücreler arası adezyon molekülü-1(ICAM-1) ve platelet-türevli büyüme faktörü(PDGF) düzeyleri ELISA yöntemiyle ölçüldü. Bulgular: Grup 3 ve 4'te adezyon skorları ve fibrozis şiddeti Grup 2'ye göre anlamlı olarak düşüktü. Plazma TNF-α değeri Grup 2'de Grup 4'e göre anlamlı olarak yüksekti. Plazma PDGF değeri Grup 2'de Grup 3 ve 4'e göre anlamlı olarak yüksekti. . Sonuç: PRF, fibroblastların ve inflamatuar hücrelerin çoğalmasını engelleyerek ve mezotelyal hücrelerin çoğalmasını teşvik ederek bağırsak yapışmasını azaltabilir. PRF, içeriğindeki büyüme faktörleri ve sitokinlere bağlı olarak antiinflamatuar etkiye sahiptir ve postop adezyonları önler.

Efficacy of pure olive oil and PRF in the prevention of postoperative peritoneal adhesions

Purpose: In this study, we applied platelet rich fibrin (PRF) and pure olive oil on the incision surfaces of rats. We aimed to examine whether PRF may be used safely to prevent peritoneal adhesions. Materials and Methods: Fourty rats were divided into 4 groups (n=8). Eight rats, not included in the study groups, were used to obtain PRF material. Group 1 had no surgical procedure, Group 2 was operated without medication, Group 3 was operated and received 1cc olive oil, Group 4 was operated and received 1 cc PRF. After 21 days, cecum areas were examined histopathologically. Tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1) and platelet-derived growth factor (PDGF) levels were measured in serum by ELISA. Results: The adhesion scores and severity of fibrosis in Group 3 and 4 were significantly lower than Group 2. Plasma TNF-α value was significantly higher in Group 2 than Group 4. Plasma PDGF value was significantly higher in Group 2 than Group 3 and 4. Discussion: PRF reduced intestinal adhesion by inhibiting the proliferation of fibroblasts and inflammatory cells, and promoting the proliferation of mesothelial cells. PRF has anti-inflammatory effect and prevented postop adhesions, based mainly on growth factors and cytokines in its content.

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