Ameliyatta kullanılan kompres postoperatif intraabdominal adezyona neden oluyor mu?
Özet
Introduction:Postoperative intraabdominal adhesions are significant causes of morbidity andmortality because of their important complications including intestinal obstruction,infertility and chronic pelvic pain. Adhesions also lead to inadvertent enterotomiesthat may occur during relaparatomies and increased health expenses.In order to expose the operative site during major abdominopelvic surgery,gauze compresses are used to keep the small intestines out of the operative field. Thegauze compress may cause serosal injury and an inflammatory reaction; thusabdominal adhesions may result.The aim of this study is to determine the effects of gauze compress and itsalternate PVC in the etiology of intraabdominal adhesions.Material and Methods:Wistar-Albino rats weighting 250-350 gr were utilized in this study. 160 ratswere randomized in three groups (control, compress and PVC) and 16 subgroups.Midline laparatomy and caecal serosal abrasion were performed to allsubjects. In control group an extractor was used to apply constant force on the smallintestines. In the compress group, a gauze compress was placed between theextractor and the small intestines, and in the PVC group large sterile IV bags wereused instead of gauze compress. In all groups, constant force was performed for 2hours.Full thickness small intestinal biopsies were taken at the 0th, 2nd, 24th, 72thhours and 7th, 14th days for the histological examination of inflammation. All theanimals were sacrificed after the biopsy.All specimens were assessed for concession, leucocyte migration,mesothelial cell proliferation and collagenization in microscopic inflammationevaluation by two blinded pathologists. The adhesions at 7th and 14th days weredetermined according to three adhesion grading systems (Nair, Knigtly and Mazuji)by a blinded examiner.Kruskal-Wallis Anova test was used for statistical analyses.