Ratlarda ovariohisterektomiyi takiben tek başına veya okside rejenere selüloz ile birlikte rifampisin kullanılarak intraabdominal adezyonun önlenmesi

Abstract

Bu çalışmanın amacı, tek başına veya okside rejenere selüloz (Surgicel) ile birlikte uygulanan rifampisinin, ovariohisterektomi (OVH) sonrası postoperatif intraabdominal adezyonları önlemedeki etkinliğini bir rat modelinde değerlendirmektir. Otuz iki dişi Wistar rata OVH uygulandı ve rastgele dört gruba ayrıldı: serum fizyolojik ile tedavi edilen bir kontrol grubu (C), Surgicel uygulama grubu (S), rifampisin uygulama grubu (R) ve hem Surgicel hem de rifampisin alan bir kombinasyon grubu (S+R). Yapışıklıkların gelişimi postoperatif 28. günde makroskopik ve histopatolojik olarak değerlendirilmiştir. Ayrıca, enflamatuar ve anjiyojenik yanıtları değerlendirmek için sırasıyla TNF-α için immünohistokimyasal boyama ve VEGF için immünofloresan boyama yapılmıştır. Makroskopik ve histopatolojik değerlendirmeler, rifampisin uygulamasının (R) kontrole kıyasla adezyon oluşumunun yoğunluğunu ve şiddetini önemli ölçüde azalttığını ortaya koymuştur. İlginç bir şekilde, S grubu kontrolle karşılaştırılabilir yapışıklık oranları sergilerken, S+R grubu yapışıklıklarda orta düzeyde bir azalma göstermiştir. İmmünohistokimyasal ve immünofloresan bulgular makroskopik gözlemleri destekleyerek rifampisinin adezyon oluşumuyla ilişkili enflamatuar ve fibrojenik yanıtları hafifletebileceğini göstermiştir. Rifampisin tek başına OVH sonrası karın içi yapışıklıkların oluşumunu ve şiddetini azaltma konusunda etkili olduğu gözlemlenmiştir. Surgicel ve rifampisin kombinasyonu sinerjik bir etki yaratmamıştır, çünkü tek başına Surgicel uygulaması yapışıklıkların önlenmesinde önemli bir etki göstermemiştir. Bu bulgular, Surgicel'in hemostaz için faydalı olmakla birlikte, adezyon oluşumuna potansiyel katkısı nedeniyle dikkatli olunması gerektiğini göstermektedir. Rifampisinin abdominal cerrahi sonrası adezyon oluşumunu engelleyebileceği farmakokinetik ve hücresel mekanizmaların aydınlatılması için daha fazla araştırma yapılması gerekmektedir.

Keywords

• İntraabdominal adezyon
• ovariohisterektomi
• rifampisin
• Surgicel
• rat modeli
• postoperatif komplikasyonlar

Prevention of intraabdominal adhesion using rifampicin alone or in combination with oxidized regenerated cellulose following ovariohysterectomy in rats

Abstract

This study aimed to evaluate the efficacy of rifampicin, administered alone or in combination with oxidized regenerated cellulose (Surgicel), in preventing postoperative intra-abdominal adhesions following ovariohysterectomy (OVH) in a rat model. Thirty-two female Wistar rats underwent OVH and were randomly assigned to four groups: a control group treated with saline (C), a Surgicel application group (S), a rifampicin administration group (R), and a combination group receiving both Surgicel and rifampicin (S+R). The development of adhesions was evaluated macroscopically and histopathologically on postoperative day 28. Additionally, immunohistochemical staining for TNF-α and immunofluorescence staining for VEGF were performed to assess inflammatory and angiogenic responses, respectively. Macroscopic and histopathological assessments revealed that rifampicin application (R) significantly reduced the intensity and severity of adhesion formation compared to the control. Interestingly, the S group exhibited adhesion rates comparable to the control, while the S+R group demonstrated a moderate decrease in adhesions. Immunohistochemical and immunofluorescence findings corroborated the macroscopic observations, indicating that rifampicin may attenuate the inflammatory and fibrogenic responses associated with adhesion formation. Rifampicin alone shows promise in reducing the formation and severity of intra-abdominal adhesions post-OVH. The combination of Surgicel and rifampicin did not yield a synergistic effect, as Surgicel application alone did not demonstrate significant efficacy in adhesion prevention. These findings suggest that while Surgicel is beneficial for haemostasis, caution should be exercised due to its potential contribution to adhesion formation. Further investigation is warranted to elucidate the pharmacokinetic and cellular mechanisms by which rifampicin might inhibit adhesion formation following abdominal surgery.

Keywords

• Intraabdominal adhesions
• ovariohysterectomy
• rifampicin
• Surgicel
• rat model
• postoperative complications

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