Cemalettin CAMCI, CÜNEYT KIRKIL, Fatih EROL, Erhan AYGEN, OSMAN DOĞRU, Refik AYTEN

Hylan GF-20 ve metil-prednizolonun laparotomi yapılan ratlarda yapışıklık oluşması üzerine etkileri

Amaç: Bu çalışmada Hylan GF-20 ve metil-prednizolonun laparotomi yapılan ratlarda yapışıklık oluşması üzerine etki gösterip göstermeyeceklerinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Kırk adet rat 4 gruba ayrılıp çekum ön duvarında 1 cm2 lik alanda steril gazlı bezle abrazyon oluşturuldu. Birinci gruptaki ratlara herhangi bir ilaç verilmez iken, 2. gruptakilere intraperitoneal 1 cc %4 Hylan GF-20 solüsyonu, 3. gruptakilere intraperitoneal 10 mg/kg metil prednizolon 4. gruptakilere intraperitoneal 1 cc %4 Hylan GF-20 solüsyonu + 10 mg/kg metil prednizolon verildi. Yedi gün sonra, grupları bilmeyen bir incelemeci tarafından daha önceki kesi hattı dışından tekrar laparotomi yapılarak kesi hattına ve çekuma olan yapışıklıklar değerlendirildi. Bulgular: Grupların çekumdaki ortalama yapışıklık sayıları sırasıyla 1.80±0.92 , 0.40±0.70, 0.90±0.74 ve 0.80±1.03 idi. Kesi hattındaki ortalama yapışıklık skorları ise sırasıyla 2.50±1.43, 0.60±0.70, 0.90±0.88 ve 0.50±0.71 idi. Tüm tedavi gruplarının yapışıklık skorları kontrol grubununkinden belirgin olarak daha düşüktü (p0,05). Sonuç: Hylan GF-20 ve metilprednizolon tek başlarına karın içi yapışıklık gelişmesini önlemede etkilidir. Birlikte kullanımları yapışıklıkları önlemedeki etkinliklerini arttırmamaktadır.

Hylan GF-20 and methyl-prednisolones effects on adhesion formation in rats underwent laparotomy

Objective: In this study we aimed to investigate if Hylan GF-20 and methyl-prednisolone will effect upon the formation of adhesions in rats underwent laparotomy. Material and Method: Forty rats were divided into 4 groups and abrasion was created with sterile gauze at 1 cm2 area on the anterior wall of the cecum. In the first group, while the rats not given any drug, in the second group 1 cc of 4% solution of Hylan GF-20, in the third group 10 mg / kg methyl prednisolone and in the fourth group 1 cc %4 Hylan GF-20 solüsyonu +10 mg / kg methyl prednisolone 10 mg / kg methyl prednisolone were given intraperitoneally. Seven days later, adhesions with incision line and cecum were evaluated by an investigator blinded to group by doing again laparotomy outside earlier incision line. Results: The average number of caecal adhesions was, respectively, 1.80 ± 0.92, 0.40 ± 0.70, 0.90 ± 0.74 and 0.80 ± 1.03. The average number of adhesions in the incision line was, respectively, 2.50 ± 1.43, 0.60 ± 0.70, 0.90 ± 0.88 and 0.50 ± 0.71. Adhesion scores of all treatment groups significantly lower than the control group (p <0.05). However, there was no statistically significant difference between treatment groups (p>0.05). Conclusion: Hylan GF-20 and methyl prednisolone individually are effective in preventing the development of intra-abdominal adhesions. Concomitant use does not increase their effectiveness in the prevention of adhesions.

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