Doku defektine sahip yaraların borik asit içeren poliüretan süngerle tedavisi (Randomize çalışma)

Year 2020, Volume: 5 Issue: 2, 83 - 90, 29.06.2020

Rana Kapukaya Özgür Külahçı

https://doi.org/10.30728/boron.650286

Abstract

Günümüzde yara tedavisinde çok çeşitli yöntemler uygulanmasına rağmen henüz istenilen başarılar elde edilememiştir. Bugün için yara tedavisinde Negatif Basınçlı Yara Tedavi (NPWT) sisteminden başarılı sonuçlar alınmaktadır. Ancak bu sistemi oluşturan değişkenlerinde optimum değerlerde henüz ortak bir görüş yoktur. Biz bu çalışmada, halihazırda kullanılan gümüş nitrat yerine, borikasit kullanarak yaraları tedavi ettik. Doku defektli yaraya sahip hastalar, Ortopedi ve Travmatoloji kliniği ile Plastik ve Rekonstriktif Cerrahi kliniğinde borik asitli süngerler ile tedavi edildi. Yeni bir teknikle hazırlanmış bu süngerler negatif basınç üreten cihaz ile kombine (VAC) edilerek yaraların yüzeylerine uygulandı. Bu çalışmaya dahil edilen 129 hasta iki gruba bölündü. Her bir grup ise iki alt grupta incelendi. Birinci grupta (akut defektif yaraya sahip hastalar) bulunan 49 hastanın 22’sine gümüş nitratlı sünger, 27’sine ise borik asit parçacıklı süngerler kullanıldı. İkinci grupta (kronik defektif yaraya sahip hastalar) bulunan 80 hastanın 36’sına gümüş nitratlı 44’üne ise borik asit parçacıklı süngerler kullanıldı. Birinci grupta borik asitli sünger uygulanan hastaların yaş ortalaması 34,25±8,89, yara boyutu 79,26±26,04 mm idi. Gümüşlü sünger kullanan grupta ise yaş ortalaması 32,85±10,95 yıl, yara boyutu ise 85,91±26,53 mm idi. İkinci grupta ise borik asitli sünger kullanan grupta hastaların yaş ortalaması 63.76±11.94 yıl idi. Yara boyutu ise ortalama 85,26±25.40 mm idi. Gümüşlü sünger kullanan grupta ise hastaların yaş ortalaması 64,16±10,12 yıl idi. Yara boyutu ise ortalama 85,91±26,53 mm idi. Her iki grubun alt grupları arasında cinsiyet, genel alışkanlıkları, yaş ve yara boyutu ve lokalizasyonun bakımından anlamlı bir fark yoktu. Bu çalışmada borik asit parçacıklı sünger kullanılan her yaranın bütün evrelerinde kısalmalar tespit edilmiş ve biyopsilerin histopatolojik incelemelerinde özellikle 10. günden itibaren inflamatuar, granülasyon angiogenesis ve epitelizasyon fazlarında anlamlı bir farkın olduğu tespit edilmiştir. Sonuç olarak yaranın hem klinik özellikleri, hem de histopatolojik sonuçları dikkate alındığında asit borikli süngerlerin, yaranın her evresinde gümüşlü süngere kıyasla daha üstün bir etkiye sahip olduğu tespit edildi.

Keywords

Borik Asit, Poliüretan sünger, Yara iyileşmesi

Supporting Institution

YOK

Project Number

57

Thanks

PROF.DR.AHMET KAPUKAYA

Treatment of tissue defect wounds with boric acid polyurethane sponge (Randomized study)

Abstract

Today, despite the application of various methods in wound treatment, the desired success has not been achieved yet. Today, successful results are obtained in Negative Pressure Wound Treatment (NPWT) system for wound treatment. However, there is no consensus on the optimum values of the variables that comprise this system. In this study, we treated wounds by using boric acid instead of silver nitrate that is currently used. Patients with tissue defect wounds were treated with sponges with boric acid in the Orthopedics and Traumatology Clinic and the Plastic and Reconstructive Surgery Clinic. Prepared with a new technique, these sponges were combined with negative pressure generating device (VAC) and applied to the surfaces of the wounds. 129 patients included in this study were divided into two groups. Each group was examined in two subgroups. Of the 49 patients in the first group (patients with acute defective wounds), 22 had silver nitrate sponges and 27 had boric acid sponges. Of the 80 patients in the second group (patients with chronic defective wounds), 36 used silver nitrate and 44 used boric acid sponges. In the first group, the mean age of the patients who were treated with boric acid sponge was 34.25 ± 8.89 and the wound size was 79.26 ± 26.04 mm. The mean age was 32.85 ± 10.95 years and the size of the wound was 85.91 ± 26.53 mm. In the second group, the mean age of the patients using the sponge with boric acid was 63.76 ± 11.94 years. The mean wound size was 85.26 ± 25.40 mm. In the silver sponge group, the mean age of the patients was 64.16 ± 10.12 years. The mean wound size was 85.91 ± 26.53 mm. There was no significant difference between the two groups in terms of gender, general habits, age and wound size and localization. In this study, shortening was determined in all stages of each wound using boric acid sponge and histopathological examination of biopsies revealed a significant difference especially in inflammatory, granulation angiogenesis and epithelization phases from day 10 onwards. As a result, considering both the clinical features and histopathological results of the wound, it was found that acid boric sponges had a superior effect at each stage of the wound compared to silver sponge.

Keywords

Boric acid, Polyurethane sponge, Wound healing

Project Number

57

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