Enoksaparin ve rivaroksabanın cilt degloving yaralanmalarında doku sağkalımı üzerindeki etkisi: Deneysel çalışma

Öz

Amaç: Çalışmamızda degloving yaralanması sonrası antitrombotik ajanlar enoksaparin ve rivaroksabanın doku sağkalımı üzerindeki etkilerini deneysel sıçan kuyruk modelinde incelemeyi amaçladık.

Çalışma planı: Yirmi dört sıçan üç eşit gruba ayrıldı (n=8): Enoksaparin verilen grup (Grup 1), rivaroksaban verilen grup (Grup 2) ve serum fizyolojik verilen kontrol grubu (Grup 3). Tüm sıçanların kuyruklarının başlangıcının yaklaşık 5 cm distalinden dairesel kesi yapıldıktan sonra kesinin distalindeki kuyruk derisine elle traksiyon uygulanarak degloving yaralanma sahası oluşturuldu. On beş dakika beklendikten sonra kesi uçları yerlerine dikildi. Dikişten hemen sonra antitrombotik ajanlar sıçanlara verildi ve işlem 15 gün boyunca günde bir kez tekrarlandı. On beşinci gün sonunda deney sonlandırıldı. Doku sağkalımı morfolojik ve histopatolojik olarak değerlendirildi.

Bulgular: Histopatolojik incelemede enoksaparin ve rivaroksaban gruplarında çoğunlukla normal cilt veya minimal enflamasyonun eşlik ettiği sağlam cilt görüldü. Nekrotik alanın kontrol grubundaki uzunluğu enoksaparin ve rivaroksaban gruplarına göre anlamlı derecede daha fazlaydı (p<0.05). Enoksaparin rivaroksaban grupları arasında istatistiksel olarak anlamlı fark saptanmadı (p=0.451). Ortalama nekrotik cilt uzunluğu kontrol grubunda çalışma gruplarına göre anlamlı düzeyde daha büyük iken (p<0.05), enoksaparin ve rivaroksaban grupları arasında nekrotik cilt uzunluğu açısından istatistiksel olarak anlamlı fark saptanmadı (p=0.722).

Çıkarımlar: Sıçan kuyruklarında degloving yaralanma modelinde, enoksaparin ve rivaroksaban kullanımının histopatolojik ve morfolojik bulgular bakımından doku sağkalımını arttırmaktadır.

Anahtar Kelimeler

• Degloving yaralanma; doku sağkalımı; enoksaparin; rat; rivaroksaban.

Effects of enoxaparin and rivaroxaban on tissue survival in skin degloving injury: an experimental study

Abstract

Objective: The aim of this study was to evaluate the effects of the antithrombotic agents enoxaparin and rivaroxaban on tissue survival following skin degloving injury in an experimental rat tail model.

Methods: The study included 24 rats divided into three equal groups of 8; the enoxaparin group (Group 1), the rivaroxaban group (Group 2) and the saline control group (Group 3). A degloving injury was created by making a circular incision 5 cm distal to the base of the tail; manual traction was applied to the tail skin distal to the incision. After 15 minutes, the ends of the incision were sutured back in place. Antithrombotic agents were administered immediately after suturing and repeated once a day for 15 days. At the end of Day 15, the experiment was terminated. Gross morphological tissue survival and histopathology were evaluated.

Results: Histopathological examination of the enoxaparin and rivaroxaban groups revealed that the skin was mostly normal or intact with minimal inflammation. The mean length of necrotic area was significantly higher in the saline group compared to the enoxaparin and rivaroxaban groups (p<0.05). No statistically significant differences were noted between the rivaroxaban and enoxaparin groups (p=0.451). The mean extent of skin necrosis was significantly higher in the control group than the study groups (p<0.05), while there was no significant difference in the length of necrotic area between Group 1 and 2 (p=0.722).

Conclusion: Rivaroxaban and enoxaparin improved tissue survival in skin degloving injuries in terms of gross morphological and histopathological findings in a rat tail model.

Keywords

• Degloving injury
• enoxaparin
• rat
• rivaroxaban
• tissue survival

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