Sıçanlarda Mastektomi ve Aksiller Diseksiyon Sonrası Seroma Gelişimi Üzerine Kriyoprezerve İnsan Amniyotik Membran ve Trombositten Zengin Plazmanın Etkileri

Amaç: Seroma, mastektomi ve aksiller lenf nodu diseksiyonu sonrası en sık görülen komplikasyonlardan bir tanesidir. Yara iyileşmesinin eksüdatif ve inflamatuar fazının uzamasının bir sonucu olarak ortaya çıkar. Bu çalışmanın amacı, insan amniyotik membranı (human amniotic membrane, HAM) ve trombositten zengin plazma (platelet-rich plasma, PRP)’nın seroma oluşumu üzerindeki etkilerini değerlendirmektir. Gereç ve Yöntemler: Toplam 24 adet sıçan kontrol, PRP ve HAM grubu olarak gruplara ayrıldı. Tüm sıçanlara radikal mastektomi ve aksiller lenf nodu diseksiyonu yapıldı. Diseksiyon bölgesine kontrol grubunda salin, ikinci grupta PRP ve üçüncü grupta ise HAM uygulandı. Tüm gruplar cerrahi alanın durumu, seroma hacmi ve histopatolojik değişiklikler açısından karşılaştırıldı. Bulgular: PRP grubunda seroma hacminde azalma görüldü, ancak HAM grubunda azalma gözlenmedi. Hem PRP hem de HAM grubunda lenfosit, eozinofil, histiyosit ve fibroblast seviyeleri kontrol grubuna göre anlamlı derecede daha düşük olduğu tespit edildi. PRP ve HAM gruplarının E-cadherin ve TGF-β1 immünreaktivitelerinin de kontrol grubuna göre daha yüksek olduğu tespit edildi. Sonuç: Bu çalışmada PRP ve kriyoprezerve HAM'ın doku iyileşmesini arttırdığı ve inflamatuar süreci azalttığı gözlendi. Ancak lokal PRP uygulanması seroma oluşumunu önemli ölçüde azaltsa da lokal HAM uygulamasının seroma oluşumunu azaltmadığı belirlendi. Bunun HAM'ın pürüzsüz yüzeyinin mekanik olarak dokuların yapışmasını engellemesinden kaynaklanabileceği düşünüldü. HAM'ın hazırlanmasında ve uygulanmasında yapılacak olan modifikasyon ile daha faydalı sonuçlar elde edilecektir.

Anahtar Kelimeler:

Aksiller diseksiyon, İnsan amniyotik membran, Mastektomi, Trombositten zengin plazma, Seroma

The Effects of Cryopreserved Human Amniotic Membrane and Platelet-Rich Plasma on Seroma Development after Mastectomy and Axillary Dissection in Rats

Aim: Seroma is one of the most common complications after mastectomy and axillary dissection. It occurs as a result of prolongation of the exudative-inflammatory phase of wound healing. The aim of this study is to evaluate the effects of human amniotic membrane (HAM) and platelet-rich plasma (PRP) on seroma formation. Material and Methods: A total of 24 rats were grouped as control, PRP, and HAM groups. All rats underwent radical mastectomy and axillary lymph node dissection. Saline in the control group, PRP in the second group, and HAM in the third group were applied to the dissection area. The groups were compared in terms of the condition of the surgical field, seroma volume, and histopathological changes. Results: Seroma volume decreased in the PRP group, but not in the HAM group. Lymphocyte, eosinophil, histiocyte, and fibroblast levels were significantly lower both in the PRP and HAM groups compared to the control group. E-cadherin and TGF-β1 immunoreactivities of PRP and HAM groups were higher than in the control group. Conclusion: In this study, it was observed that PRP and cryopreserved HAM increased tissue healing and decreased the inflammatory process. However, although local PRP application significantly reduced seroma formation, it was determined that HAM application did not reduce seroma formation. It was thought that this might be due to the fact that the smooth surface of HAM mechanically prevents the adhesion of the tissues. More beneficial results will be obtained with the modification to be made in the preparation and application of HAM.

Keywords:

Axillary dissection, Human amniotic membrane, Mastectomy, Platelet-rich plasma, Seroma,

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