VENTRAL HERNİ ONARIMINDA POLİPROPİLEN VE SİLİKON KAPLI POLİPROPİLEN YAMANIN RAT MODELİNDE KARŞILAŞTIRILMASI Comparison of Polypropylene and Silicone-Coated Polypropylene Mesh in Repair of Ventral Hernia in a Rat Model

Yıl 2019, Cilt: 9 Sayı: 1, 35 - 41, 26.03.2019

Yılmaz Ünal Arif Hakan Demirel Berkay Küçük Salih Tuncal Muzaffer Çaydere

Öz

ÖZET

Amaç: Bu çalışma ventral herni tamirinde polipropilen bir yama ile silikon tabaka ve silikon kaplı

polipropilen yamanın etkinliğini karşılaştırmayı amaçlamaktadır.

Gereç ve Yöntem: Toplam 45 Wistar Albino rat 3 eşit gruba ayrıldı(polipropilen yama grubu, silikon

tabaka grubu ve silikon kaplı polipropilen yama grubu). Tüm ratlara 3 cm’lik orta hat insizyonu yapılarak

abdominal defekt oluşturuldu. Defektler polipropilen yama, silikon tabaka ve silikon kaplı

polipropilen yama ile onarıldı. Yamalar doğrudan intraabdominal organlar üzerine yerleştirildi.

Tüm ratlar postoperatif 28.günde sakrifiye edildi. İntraabdominal yapışıklıklar değerlendirildi ve

dokuların kopma kuvvetleri ölçüldü. Histopatolojik değerlendirme için doku örnekleri alındı.

Bulgular: Silikon kaplı polipropilen yama grubunda ortalama adezyon skoru, polipropilen yama

ve silikon tabaka grubundaki ortalama adezyon skorundan anlamlı olarak daha düşük bulundu.

Silikon tabaka grubunda yaranın histopatolojik maturasyon derecesi diğer iki gruptan anlamlı olarak

daha düşüktü. Yama materyallerinin kopma kuvvetleri karşılaştırıldığında; polipropilen yama

grubundaki kopma kuvvetleri diğer iki gruptaki kopma kuvvetlerinden anlamlı olarak daha yüksek

tespit edildi.

Sonuç: Ventral herni tamirinde silikon kaplı bir polipropilen yamanın kullanımı yama ve bağırsaklar

arasında yapışıklığa sebep olmadı ve yama ile omental yapılar arasındaki yapışıklıkları da azalttı.

Anahtar Sözcükler: Cerrahi yama; Ventral herni; Polipropilen; Silikon; Yapışıklıklar

ABSTRACT

Objective: The aim of this study was to compare the efficacy of a silicone sheet(SS) and siliconecoated

polypropylene mesh( SCPM) with a polypropylene mesh(PM) in ventral hernia repair.

Materials and methods: A total of 45 Wistar Albino rats were randomly separated into 3 groups of

15(PM group, SS group and SCPM group). An abdominal defect was created in all the rats using a 3

cm midline incision. The defects were repaired with SS, PM or SCPM meshes which were placed

directly over the abdominal organs. All the rats were sacrificed on postoperative day 28. The intraabdominal

adhesions were evaluated and the breaking strength of the tissues was measured.

Tissue samples were taken from the mesh-fascia junction for the histopathological evaluation.

Results: The mean adhesion score of the SCPM group was found to be significantly lower than

that of the SS and the PM groups. The histopathological wound maturation degree in the SS group

was significantly lower than that of the other two groups. Comparison of the breaking strength

of the mesh materials determined significantly higher breaking strength values in the PM group

compared with the other two groups.

Conclusion: In the repair of ventral hernia, the use of a SCPM did not cause adhesions between

the mesh and the intestines and reduced adhesions between the mesh and omental structures.

Keywords: Surgical mesh; Ventral hernia; Polypropylene; Silicone; Adhesions

Anahtar Kelimeler

VENTRAL HERNİ ONARIMINDA POLİPROPİLEN VE SİLİKON KAPLI POLİPROPİLEN YAMANIN RAT MODELİNDE KARŞILAŞTIRILMASI Comparison of Polypropylene and Silicone-Coated Polypropylene Mesh in Repair of Ventral Hernia in a Rat Model

Kaynakça

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