Ali BELGE, Nazmi ATASOY, Bahtiyar BAKIR, Musa GENÇCELEP, Yavuz GÜLBAHAR

Enterotomilerde doku yapıştırıcı fibrin glue kullanımı

Bu çalışmada, barsak cerrahisinde fibrin yapıştırıcı kullanımının iyileşme süreci ve olası postoperatif komplikasyonları önlemede etkinliği araştırıldı. Bu amaçla; 12 adet köpekte enterotomi yapılarak, operasyon yaraları 8 köpekte deneme grubu tek kat schmieden dikişine ilave olarak 0.5 mL fibrin yapıştırıcı Tisseel Kit IQ PCR , 4 köpekte kontrol grubu de rutin lumenli organ dikişleri ile kapatıldı. Çalışma süresince genel ve lokal enfeksiyon bulguları gözlenmedi. Postoperatif 10. ve 20. günlerde deneme grubundan 4'er, kontrol grubundan 2’şer köpekte laparatomi yapılarak karın boşluğu incelendi, histopatolojik kontroller için doku örnekleri alındı. Postoperatif 10. günde kontrol grubunda daha fazla olmak üzere her iki grupta da yangısal reaksiyon ve periferal yapışma, 20. günde ise kontrol grubunda yangısal dokunun normale dönmesine rağmen barsakta daralma ve periferal yapışma; deneme grubunda daralma olmaksızın, yapışma gözlenmeyen düzgün bir iyileşme saptandı. Histopatolojik kontrollerde 10. günde fibrin uygulanan grupta yangısal reaksiyonun hemen hemen ortadan kalktığı gözlenirken; 20. günde normal mukoza iyileşmesi saptandı. Çalışma sonunda; lumenli organlarda tek kat dikişe ilave olarak fibrin yapıştırıcı uygulamanın lumen daralması, intraabdominal sızıntı önlemesi ve zaman kazanımı açısından pratik bir öneme sahip olduğu kanısına varıldı

Anahtar Kelimeler:

Fibrin yapıştırıcı, Enterotomi, Barsak, Köpek

The usage tissue sealant fibrin glue in enterotomy

İn this study; the effıciacy on wound healing and preventive effects on postoperative complications of the usage of fibrin sealant in intestine surgery were investigated. For this purpose enterotomy operation was performed in twelve dogs. Operation wounds were closed with single üne schmieden suture and its on amount of 0.5 mL fibrin sealant Tisseel Kit IQ PCR was applied on suture line in eight dogs trial group ; and were closed to routin double layers sutures in four dogs control group . No local and general infection fındings were obtained during experiment in both groups. On postoperative days 10. and 20., the abdominal cavities of four dogs in trial group and two dogs in control group by laparotomy were obtained and tissue samples were collected for histopathological examinations. On postoperative day 10., inflammatory reaction and peripheral adhesion were determined, as being more in control group, in both group. On postoperative day 20., although inflammatory tissues became normal, shrinking and peripheral adhesions in intestine were determined in control group. On the other hand, smooth recovery was seen without shrinking and adhesion in trial group. In histopathological examinations, as almost removed inflammatory reaction obtained on postoperative day 10., normal mucosa healing was determined, on postoperative day 20th, in trial group. In conclusion, it was decided that the usage of fibrin sealant applied on single layer suture had a practical important for preventive of shrinking of lumen, preventive of intraabdominal leakage and gain time

Keywords:

Fibrin sealant, Enterotomy, intestine, Dog,

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