Ersin BORAZAN, İlyas BAŞKONUŞ, Avni GÖKALP, Göktürk MARALCAN, Hüseyin AĞTAŞ

Comparison of 4% icodextrin and auto-crosslinked hyaluronic acid gel in terms of efficacy and cost effectivity in preventing postoperative abdominal adhesions

Bu deneysel çalışmada intraabdominal yapışıklıkta %4 icodextrin ve hyaluronik asitin etkinliği ve maliyetinin karşılaştırılması planlandı. Bu çalışmaya her biri 250-300 gr. 30 sağlıklı Wistar albino ratlar alındı. Her grupta ratlara çekal-ileal abrazyonu takiben: Grup1 (kontrol n:10) 5 ml saline irrigasyon; Grup 2 (n:10) 5 ml %4 icodextrin solüsyonu; grup 3 (n:10) 3ml auto-crosslinked hyaluronik asit jel uygulandı. 14 gün sonra ikinci bir ameliyatı takiben gruplar arasında yapışıklık skorlaması, histopatolojik değerlendirme (inflamasyon, fibrozis) ve maliyetler karşılaştırıldı. En düşük ameliyat sonrası yapışıklık skorlaması Grup 3te, en yüksek grup 1de bulundu (p:0.028). Grup 3, grup 2den belirgin olmayacak şekilde daha düşük yapışıklık skorlamasına sahipti (p>0,05). İnflamasyon ve fibrozis açısından grup 2 en düşük skora sahipti. Ancak tüm gruplar arasında anlamlı farklılık yoktu (p>0,05). Maliyet yönünden %4 icodextrin hyaluronik asitten daha ucuzdu. Bulgular hem hyaluronik asit hem de icodextrinin ameliyat sonrası intraabdominal yapışıklıkları azaltmada benzer etkinlikte olduğunu gösterdi. Ek olarak %4 icodextrinin klinik çalışmalar için avantajlı olabilecek şekilde maliyeti daha düşüktü.

Ameliyat sonrası abdominal yapışıklıkların önlenmesinde %4 icodextrin ile auto- crosslinked hyaluronic asit jel'in etkinlik ve maliyet yönünden karşılaştırılması

This experimental study was designed to compare the effects and costs of 4% icodextrin and hyaluronic acid in intraabdominal adhesion formation in rats. This study included 30 healthy Wistar albino rats, each weighing 250-300 gr. Following cecal-ileal abrasion to rats in each group, the following treatments were applied: Group 1 (control, n:10) 5 ml saline irrigation; Group 2 (n:10) 5 ml 4% icodextrin solution; Group 3 (n:10) 3 ml auto-crosslinked hyaluronic acid gel. After 14 days, following a second operation, adhesion intensity scoring, histopathological assessment (inflammation, fibrosis) and costs were compared between groups. The lowest postoperative adhesion intensity score was found in the group 3 and the highest score was found in the group 1 (p=0.028). Group 3 had a non-significantly lower adhesion intensity score than group 2 (p>0.05). In terms of inflammation and fibrosis, group 2 had the lowest score, but there were no significant differences between all the groups (p>0.05). In terms of cost, 4% icodextrin is less expensive than hyaluronic acid. The results demonstrated that both hyaluronic acid and 4% icodextrin are similarly effective in reducing postoperative intraabdominal adhesions. In addition, 4% icodextrin is more cost-effective, which can be an advantage for clinical studies.

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