Histologic effects of hyperbaric oxygen therapy administered immediately after or two hours after ischemia-reperfusion injury: a rat abdominal skin flap model

Yıl 2003, Cilt: 10 Sayı: 1, 18 - 24, 10.04.2003

Hakan Ağır Berkan Mersa Şamil Aktaş Vakur Olgaç

Öz

Objectives: İn a rat abdominal skin flap model, we investi- gated the histologic effects of hyperbaric oxygen HBO ther­ apy on the skin flaps and the lung tissue immediately after and two hours after ischemia-reperfusion injury İRİ .Study Design: Thirty Sprague-Davvley rats vvere assigned to three groups equal in number. The first group vvas left as Con­ trols. The left inferior abdominal skin flap based on the superficial inferior epigastric vessels vvas elevated. Follovving 10 hours of global ischemia, HBO therapy vvas started immediately after and tvvo hours after reperfusion in groups 2 and 3, respectively.Our protocol included a course of 16 HBO treatments in six days at 2.5 ATA for 90 minutes, vvith four sessions on the first day, three sessions on the second and third days, and tvvo sessions on the fourth, fifth, and sixth days. On the sixth day, survival rates for ali flaps vvere calculated. Histologic examination vvas made on specimens taken from rat flaps and lungs.Results: The mean flap survival vvas 25.87% in the control group.İt significantly increased to 90.93% and 84.34% in HBO-treated rats in groups 2 and 3, respectively p<0.001 . There vvas no sig- nificant difference betvveen HBO-treated groups p>0.05 .Histologically, neither minör nor majör changes vvere observed in HBO-treated rat lung tissues. Similarly, compared to the Controls, thrombosis in flap microvasculature, intimal damage, edema, neu- trophil infiltration, and necrosis vvere considerably less and neo- vascularization vvas significantly higher in HBO-treated flap tissues.Conclusion: Intense HBO treatment protocol used in this study significantly increases flap survival in rataxial skin flap model and reduces deleterious effects of İRİ.

Anahtar Kelimeler

Graft survival, hyperbaric oxygenation, ischemia/physiopathology/metabolism, necrosis/prevention & control, oxygen/pharmacology, rats, reperfusion injury/physiopathology/etiology/prevention & control, surgical flaps, time factors, transplantation, autologous

Sıçan karın deri flebi modelinde, iskemi-reperfüzyon hasarından hemen sonra ve iki saat sonra uygulanan hiperbarik oksijen tedavisinin histolojik etkileri

Öz

Amaç: Sıçan karın deri flebi modelinde iskemi-reperfüzyonhasarından İRH hemen sonra ve iki saat sonra uygulananhiperbarik oksijen tedavisinin sıçan akciğer dokusu ve fleplerdeki histolojik etkileri arafltırıldı.Çalıflma Pl a n ı : Sprague-Dawley türü sıçandan 10’ar adetlik üçgrup oluflturuldu. Sıçanların sol taraf karın bölgesindeki süperfisyal inferior epigastrik pediküllü deri flepleri kaldırıldı. On saatlik global iskeminin ardından reperfüzyona bırakılan fleplerdeİRH oluflturuldu. Birinci grup kontrol grubu olurken, HBO tedavisine ikinci grupta reperfüzyonun hemen ardından, üçüncügrupta ise iki saat sonra bafllandı. Tedavi protokolü, 2.5 ATA’ d a10 dakikalık iki hava molası ile 90 dakika olarak, ilk gün dört seans, sonraki iki gün üçer seans, son üç gün ikifler seans olmaküzere toplam altı gün 16 seans uygulandı. Altıncı gün fleplerinyaflam oranları hesaplandı. Sıçan flep ve akciğerlerinden alınan örnekler histolojik olarak değerlendirildi. Bu l g u l a r : Kontrol grubunda ortalama %25.87 oranında flepcanlılığı gözlendi. Bu oran, reperfüzyonun ardından hemen tedaviye bafllandığında %90.93’e, iki saat sonra bafllandığında%84.34’e çıktı. Kontrol grubu ve tedavi grupları arasında istatistiksel olarak anlamlı fark bulundu p0.05 .Histolojik kesitlerin incelenmesi, yoğun HBO’nun sıçan akciğerlerinde değiflikliğe neden olmadığını, İRH’nin fleplerde yol açtığıolumsuz değifliklikleri azaltığını, dokuları koruduğunu gösterdi.Sonu ç : Kullandığımız yoğun HBO tedavi protokolü, İRH’li sıçankarın deri flebinde, doku yaflamını destekleyerek canlılığı anlamlı derecede artırmakta ve hasarın boyutlarını azaltmaktadır

Anahtar Kelimeler

Graft canlılığı, hiperbarik oksijenasyon, iskemi/fizyopatoloji/metabolizma, nekroz/önleme ve kontrol, oksijen/farmakoloji, sıçan, reperfüzyon hasarı/fizyopatoloji/etyoloji/önleme ve kontrol, cerrahiflepler, zaman faktörü, transplantasyon, otolog

Kaynakça

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