Mehmet GAMSIZKAN, Onur GENÇ, Sedat GÜRKÖK, Orhan YÜCEL, Hasan ÇAYLAK, Ersin SAPMAZ, Sezai ÇUBUK, Kuthan KAVAKLI

İnsan amniyon sıvısının pektus cerrahisinde kullanılan sternotominin iyileşmesi üzerindeki etkileri: Deneysel çalışma

Amaç: Bu çalışmada insan amniyon sıvısının sternotomi hattının iyileşmesi üzerindeki etkileri araştırıldı. Çalışma planı: Çalışmada 200-300 gr ağırlığında 30 adet Wistar albino cinsi erkek sıçan kullanıldı. Sıçanlar kontrol grubu ve çalışma grubu olmak üzere iki gruba ayrıldı Osteotomi her sıçanda aynı bölgeye uygulandı. Sıçanların her birinden biyokimyasal parametreler için kan örnekleri alındı ve kemik grafileri çekildi. Çalışma grubunda osteotomi hattına insan amniyon sıvısı uygulandı. Sıçanlar 1, 2. ve 4. haftalarda sakrifiye edildi. Doku örnekleri histopatolojik olarak incelendi.Bulgular: Histopatolojik incelemede gruplar arasında anlamlı fark tespit edilemedi, fakat bazı biyokimyasal parametreler açısından mevcut olan farklar istatistiksel olarak anlamlı idi. Röntgen sonuçları arasında da anlamlı fark bulunamadı.Sonuç: İnsan amniyon sıvısı temini ve uygulanabilirliğinin kolay olması nedeni ile kırık iyileşmesinde kullanılabilecek alternatif ajanlar arasında değerlendirilebilir.

Effects of human amniotic fluid on the healing of sternotomy used in pectus surgery: experimental study

Background: In this article we studied the effects of human amniotic fluid on the healing of sternotomy line. Methods: Thirty male Wistar albino rats weighing 200-300 gr were used in this study. The rats were divided into two groups as the control group and the study group. Osteotomy was performed on same region in each rat. Blood samples were obtained from each rat for biochemical studies and bone X-rays were taken. Human amniotic fluid was applied on the osteotomy line in the study group. The rats were sacrified at 1th, 2nd, and 4th weeks. Tissue samples were examined histopathologically.Results: No statistically significant differences were found between the groups in the histopathologic examinations, although the differences in some biochemical parameters were statistically significant. There were also no significant differences between the X-ray results.Conclusion: The human amniotic fluid can be considered as an alternative agent, which is easy to provide and apply also can be used to improve fracture healing.

PDF

___

1) Genc O, Gurkok S, Gözübüyük A, Dakak M, Caylak H, Yücel O. Repair of pectus deformities: experience and outcome in 317 cases. Ann Saudi Med 2006;26:370-4.
2) Robbins SL, Kumar V, editors. Basic pathology. 4th ed. Philadelphia: W.B. Saunders Co.; 1987. Robins SL, Kumar V. Kemik onarımı. Çeviri editörü: Uluoğlu Ö. Patoloji. Ankara: Güneş Kitabevi; 1990. s. 65-6.
3) Brown SG, Kramers PC. Indirect (secondary) bone healing. In: Bojrab MJ, editor. Disease mechanisms in small animal surgery. 2nd ed. Philadelphia: Lea & Febiger; 1993. p. 671-7.
4) Remedios A. Bone and bone healing. Vet Clin North Am Small Anim Pract 1999;29:1029-44.
5) Hulse D, Hyman B. Fracture biology and biomechanics. In: Slatter D, editor. Textbook of small animal surgery. 2nd ed. Philadephia: W.B. Saunders; 1993. p. 1595-603.
6) Johnson AL, Eurell JC, Losonsky JM, Egger EL. Biomechanics and biology of fracture healing with external skeletal fixation. Compend Contin Educ Pract Vet 1998;20:487-502.
7) Denny HR, Butterworth S. Fracture healing. In: Denny HR, Butterworth S, editors. A guide to canine and feline orthopaedic surgery. 4th ed. London: Blackwell Seince; 2000. p. 3-17.
8) Skerry TM. Fracture healing. In: Coughlan AR, Miller A, editors. Bsava manual of small animal fracture repair and management. 1st ed. England: BSAVA; 1998. p. 29-42.
9) Perren SM. Primary bone healing. In: Smeak DD, Bojrab MJ, Bloomberg MS, editor. Disease mechanisms in small animal surgery. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 1993. p. 663-70.
10) Noyan A. Kemik dokusu ve kemikleşme. In: Noyan A, editör. Yaşamda ve hekimlikte fizyoloji. 10. baskı. Ankara: Meteksan Yayınları; 1998. p. 1046-7.
11) Burd DA, Greco RM, Regauer S, Longaker MT, Siebert JW, Garg HG. Hyaluronan and wound healing: a new perspective. Br J Plast Surg 1991;44:579-84.
12) Michalsky MP, Lara-Marquez M, Chun L, Besner GE. Heparin-binding EGF-like growth factor is present in human amniotic fluid and breast milk. J Pediatr Surg 2002;37:1-6.
13) Dahl LB, Kimpton WG, Cahill RN, Brown TJ, Fraser RE. The origin and fate of hyaluronan in amniotic fluid. J Dev Physiol 1989;12:209-18.
14) Longaker MT, Adzick NS, Hall JL, Stair SE, Crombleholme TM, Duncan BW, et al. Studies in fetal wound healing, VII. Fetal wound healing may be modulated by hyaluronic acid stimulating activity in amniotic fluid. J Pediatr Surg 1990;25:430-3.
15) Ozgenel GY, Samli B, Ozcan M. Effects of human amniotic fluid on peritendinous adhesion formation and tendon healing after flexor tendon surgery in rabbits. J Hand Surg Am 2001;26:332-9.
16) Kerimoğlu S, Livaoğlu M, Sönmez B, Yuluğ E, Aynaci O, Topbas M, et al. Effects of human amniotic fluid on fracture healing in rat tibia. J Surg Res 2009;152:281-7.
17) Ozgenel GY, Filiz G, Ozcan M. Effects of human amniotic fluid on cartilage regeneration from free perichondrial grafts in rabbits. Br J Plast Surg 2004;57:423-8.
18) Karaçal N, Koşucu P, Cobanglu U, Kutlu N. Effect of human amniotic fluid on bone healing. J Surg Res 2005; 129:283-7.
19) Develioglu H, Unver Saraydin S, Kartal U. The bone-healing effect of a xenograft in a rat calvarial defect model. Dent Mater J 2009;28:396-400.
20) Jacobsson SA, Djerf K, Ivarsson I, Wahlström O. Effect of diclofenac on fixation of hydroxyapatite-coated implants. An experimental study. J Bone Joint Surg [Br] 1994;76:831-3.
21) Özcan A, Yüncü M, Dalkız M, Yapar M. Kemik defektlerinin iyileşmesinde Hidroksilapatitin etkisinin değerlendirilmesi (Deneysel çalışma). T Klin Diş Hek Bil 2000;6:138-44.
22) Overgaard S, Søballe K, Lind M, Bünger C. Resorption of hydroxyapatite and fluorapatite coatings in man. An experimental study in trabecular bone. J Bone Joint Surg [Br] 1997;79:654-9.
23) Wang G, Yang H, Li M, Lu S, Chen X, Cai X. The use of silk fibroin/hydroxyapatite composite co-cultured with rabbit bone-marrow stromal cells in the healing of a segmental bone defect. J Bone Joint Surg [Br] 2010;92:320-5.
24) Benlidayi ME, Kürkcü M, Oz IA, Sertdemir Y. Comparison of two different forms of bovine-derived hydroxyapatite in sinus augmentation and simultaneous implant placement: an experimental study. Int J Oral Maxillofac Implants 2009; 24:704-11.
25) Canettieri AC, Colombo CE, Chin CM, Faig-Leite H. Femur bone repair in ovariectomized rats under the local action of alendronate, hydroxyapatite and the association of alendronate and hydroxyapatite. Int J Exp Pathol 2009;90:520-6.
26) Herbenick MA, Sprott D, Stills H, Lawless M. Effects of a cyclooxygenase 2 inhibitor on fracture healing in a rat model. Am J Orthop (Belle Mead NJ) 2008;37:E133-7.
27) Nyquist F, Halvorsen V, Madsen JE, Nordsletten L, Obrant KJ. Ethanol and its effects on fracture healing and bone mass in male rats. Acta Orthop Scand 1999;70:212-6.
28) Esenyel M, Bülbül M, Esenyel CZ, Kara AN, Bilgiç B. Kalsitoninin kırık iyileşmesi üzerine etkisi: histopatolojik ve radyografik deneysel çalışma. Türk Fiz Tıp Rehab Derg 2005;51:6-8.
29) Bulbul M, Esenyel CZ, Esenyel M, Ayanoglu S, Bilgic B, Gulmez T. Effects of calcitonin on the biomechanics, histopathology, and radiography of callus formation in rats. J Orthop Sci 2008;13:136-44.
30) Akman Ş, Göğüş A, Şener N, Bilgiç B, Aksoy B. Sıçan tibya kırıkları sonrası uygulanan diklofenak-sodyumun kırık kaynaması üzerine etkileri: deneysel çalışma. Hacettepe Ortopedi Dergisi 2001;11:55-60.