EFFECTS OF THYMOQUINONE, ZEOLITE AND PLATELET RICH PLASMA ON THE HEALING OF ISCHEMIC COLONIC ANASTOMOSIS

Yıl 2019, Cilt: 21 Sayı: 1, 65 - 72, 30.04.2019

Faruk Pehlivanlı , Gökhan Karaca Oktay Aydın , Canan Altunkaya , İbrahim Tayfun Şahiner Hüseyin Özden , Hafize Uzun Mevlüt Recep Pekicici

https://doi.org/10.24938/kutfd.522809

Cited By: 2

Öz

Objective: Anastomosis on ischemic intestines is a problematic issue in daily surgical routine. In this study, we investigated the potential effects of thymoquinone, zeolite and platelet rich plasma.

Material and Methods: Fifty rats were divided into five groups.  In the sham group all rats underwent colonic anastomosis without any ischemic insult. Colonic anastomosis was performed after mesenteric ischemia was induced by clamping the superior mesenteric artery in other study groups.  In the control group, no medication was given to the rats after ishemic anastomosis. In Zeolite group and thymoquinone group, Zeolite and thymoquinone were applied locally on the anastomosis.  In the platelet rich plasma group, platelet rich plasma was applied locally on the anastomosis. All the rats were sacrified on the 10th day. Blood and tissue samples were retrieved.

Results: Hydroxyproline levels were not different between the groups. Bursting pressure was higher in the thymoquinone group than the control group. Reepithelization was higher than the zeolite group in the sham and thymoquinone groups. TNF-α and IL 1β levels were significantly higher in the sham group than all the other groups. TNF-α and IL 1β levels were also significantly higher in the thymoquinone, zeolite and platelet rich plasma groups than the control group and higher in the thymoquinone group than the zeolite and platelet rich plasma groups. Inflammation and ischemic necrosis levels were not different between the groups.

Conclusion: Our data is suggesting that thymoquinone and platelet rich plasma have positive effects on ischemic anastomosis healing, while thymoquinone has the best results.

Anahtar Kelimeler

Nigella sativa, zeolite, platelet rich plasma, ischemia, anastomosis

İskemik Kolon Anastomoz İyileşmesinde Timokinon, Zeolit ve Plateletten Zengin Plazmanın Etkinliği

Öz

Amaç: Günlük cerrahi rutinde iskemik barsakların anastomozu önemli bir sorundur. Biz bu çalışmada timokinon, zeolit ve plateletten zengin plazmanın potansiyel etkilerini araştırdık.

Gereç ve Yöntemler: Toplam elli rat beş gruba ayrıldı. Sham grubuna iskemi olmaksızın kolonik anastomoz yapıldı. Çalışma gruplarında superior mezenterik arterin klemplenmesiyle oluşturulan mezenterik iskemi sonrası kolon anastomozu yapıldı. Kontrol grubuna iskemik anastomoz sonrası ilaç verilmedi. Zeolit, timokinon ve plateletten zengin plazma grubunda ilaç lokal olarak uygulandı. 10. günde ratlar sakrifiye edildi, doku ve kan örnekleri alındı.

Bulgular: Hidroksiprolin seviyelerinde gruplararası fark yoktu. Patlama basıncı timokinon grubunda kontrol grubuna göre daha yüksekti. Reepitelizasyon sham ve timokinon grubuna göre zeolit grubunda daha yüksekti. Sham grubunda diğer gruplara kıyasla TNF-α ve IL 1β düzeyleri anlamlı olarak yüksekti. Ayrıca TNF-α ve IL 1β düzeyleri timokinon, zeolit ve plateletten zengin plazma gruplarında kontrol grubuna göre anlamlı olarak yüksekti ve bu üçü arasında timokinon grubunda en yüksekti. İnflamasyon ve iskemik nekroz seviyeleri arasında gruplar arası anlamlı fark yoktu.

Sonuç: Sonuçlarımız timokinon ve plateletten zengin plazma’nin iskemik anastomoz iyileşmesi üzerine olumlu etkileri olduğunu göstermiş ve timokinon ile en iyi sonuçlar elde edilmiştir.

Anahtar Kelimeler

Nigella sativa, zeolit, plateletten zengin plazma, iskemi, anastomoz

Kaynakça

• 1. Li Y, Li H, Xiao L, Zhou L, Shentu J, Zhang X et al. Hemostatic efficiency and wound healing properties of natural zeolite granules in a lethal rabbit model of complex groin injury. Materials. 2012;5(12):2586-96.
• 2. Selçuk CT, Durgun M, Tekin R, Yolbas I, Bozkurt M, Akçay C et al. Evaluation of the effect of TMQ treatment on wound healing in a rat burn model. J Burn Care Res. 2013;34:e274-81.
• 3. Erkut A, Cure MC, Kalkan Y, Balık MS, Güvercin Y, Yaprak E et al. Protective effects of TMQ and alpha-tocopherol on the sciatic nerve and femoral muscle due to lower limb ischemia-reperfusion injury. Eur Rev Med Pharmacol Sci. 2016;20(6):1192-202.
• 4. Karaca G, Aydin O, Pehlivanli F, Altunkaya C, Uzun H, Güler O et al. Effectiveness of thymoquinone, zeolite, and platelet-rich plasma in model of corrosive oesophagitis induced in rats. Ann Surg Treat Res. 2017;92(6):396-401. doi: 10.4174/astr.2017.92.6.396. Epub 2017 May 29.
• 5. Bakacak M, Bostanci MS, İnanc F, Yaylali A, Serin S, Attar R et al. Protective effect of platelet rich plasma on experimental ıschemia/reperfusion ınjury in rat ovary. Gynecol Obstet Invest. 2016;81(3):225-31. doi: 10.1159/000440617. Epub 2015 Oct 24.
• 6. Kontopodis N, Tavlas E, Papadopoulos G, Panditis D, Kafetzakis A, Chalkiadakis G, Iaonnou C. Effectiveness of platelet-rich plasma to enhance healing of diabetic foot ulcers in patients with concomitant peripheral arterial disease and critical limb ıschemia. Int J Low Extrem Wounds. 2016;15(1):45-51.
• 7. Zhou B, Ren J, Ding C, Wu Y, Chen J, Wang G et al. Protection of colonic anastomosis with platelet-rich plasma gel in the open abdomen. Injury. 2014;45(5):864-8.
• 8. Yol S, Tekin A, Yilmaz H, Kücükkartallar T, Esen H, Çağlayan O et al. Effects of platelet rich plasma on colonic anastomosis. J Surg Res. 2008;146(2):190-4.
• 9. Dhurat R, Sukesh M. Principles and methods of preparation of platelet-rich plasma: a review and author’s perspective. Journal of Cutaneous and Aesthetic Surgery. 2014;7(4):189-97.
• 10. Kuru S, Kismet K, Bag YM, Barlas AM, Senes M, Durak M et al. Does the application of Ankaferd Blood Stopper rectally have positive effects on the healing of colorectal anastomosis and prevention of anastomotic leakage? An experimental study. Biomed Pharmacother. 2017;96:968-73. doi: 10.1016/j.biopha.2017.11.140.
• 11. Alzoghaibi MA, Al-Oraini AI, Al-Sagheir AI, Zubaidi AM. Temporal expression of IL 1β and IL 1Β0 in rat skin, muscle, small bowel, and colon wounds: a correlative study. J Basic Clin Physiol Pharmacol. 2014;25(2):205-10.
• 12. Steed DL. The Role of Growth Factors in Wound Healing. Surgical Clinics of North America. 1997;77(3):575-86.
• 13. Tadros T, Traber D, Heggers JP, Herndon DN. Effects of interleukin-1α administration on intestinal ischemia and reperfusion injury, mucosal permeability, and bacterial translocation in burn and sepsis. Annals of Surgery. 2003;237(1):101-9.