Effects of heparin and prednisolone on postoperative intra-abdominal adhesions in Wistar rats

Abstract

Aim: Postoperative intra-abdominal adhesions are one of the complications surgeons want to avoid. It was aimed to compare the effects of physiological saline, heparin, Ringer’s lactate, and prednisolone, which have been commonly used for surgical adhesions, with repeated lavage on postoperative adhesions.
Methods: Upon the approval of the Ethics Committee of Fırat University, Faculty of Medicine, 35 Wistar Albino (female) rats were randomized into 5 groups (Heparin BID, Heparin QD, Prednisolone QD, Prednisolone BID, and Control) of 7 rats, and adhesion was created with peritoneal injury model in all rats. The differences in the adhesions created between groups were compared using the macroscopic adhesion scoring system of Linsky.
Results: No significant differences were found between physiological saline-heparin and Ringer's lactate-prednisolone groups in terms of adhesion scores (P=0.06). There was a difference in adhesion severity on the left only in the groups receiving heparin QD and prednisolone QD (P=0.04).
Conclusion: We demonstrated that none of the agents (Physiological saline, Heparin, Ringer's lactate, and prednisolone) we used in our study model reduced adhesions. It is thought that no difference was detected because of the adhesion model we established. Advanced technology-based studies are still needed to prevent postoperative intra-abdominal adhesions that are globally observed to reduce a huge economic burden and decrease mortality and morbidity.

Keywords

• Anima models,Heparin,Postoperative intra-abdominal adhesions

Wistar cinsi ratlarda heparin ve prednizolonun postoperatif intra-abdominal adezyonlara etkisi

Öz

Amaç: Cerrahi sonrası postoperatif batın içi yapışıklıklar halen cerrahların karşılaşmak istemediği bir sorun olarak karışımıza çıkmaya devam etmektedir. Serum fizyolojik, Heparin, Ringer laktat ve prednizolonun mükerrer lavaj ile postoperatif adezyonlar üzerine etkisini karşılaştırmaktır.
Yöntemler: Fırat Üniversitesi Tıp Fakültesi Etik Kurulu’nun onayı alındıktan sonra 7’şerli 5 grup (Heparin günde 2 defa, Heparin günde 1 defa, Prednizolon günde 1 defa, Prednizolon günde 2 defa ve Kontrol) halinde toplam 35 adet Wistar Albino tipi (dişi) rat kullanılmış, tüm ratlarda peritoneal hasar paterni ile adezyon oluşturulmuştur. Her grupta oluşan adezyonlar Linsky’nin kullandığı adezyonları skorlayan, makroskopik adezyon skorlama yöntemiyle gruplar arası farklılıklar kıyaslanmıştır.
Bulgular: Serum fizyolojik-heparin ve Ringer laktat-prednizolon gruplarının karşılaştırılmasında adezyon skoru açısından istatistiksel fark bulunmamıştır (P=0,06). Sadece Heparin günde bir defa ve prednizolon günde bir defa alan gruplarda solda adezyon şiddeti bakımından istatistiksel farklılık bulunmuştur (P=0,04).
Sonuç: Çalışma modelimize göre kullandığımız Serum fizyolojik, Heparin, Ringer laktat ve prednizolonun adezyonları azaltmadığını kanıtladık. Fark olmamasının nedeninin, oluşturduğumuz adezyon modelinden kaynaklandığı düşünülebilir. Tüm dünyada mortalite ve morbiditeyi arttıran postoperatif batın içi adezyonlarını önlemede ileri teknolojik tabanlı çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler

• Hayvan modeli,Heparin,Postoperatif intra-abdominal adezyon

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