Hiperbarik oksijen tedavisinin silikon meme protez çevresinde kapsül oluşumu üzerine etkisinin histopatolojik olarak incelenmesi : Deneysel çalışma
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Dosyalar
Tarih
2017
Yazarlar
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Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Meme operasyonlarında sık olarak silikon meme protezleri kullanılmaktadır. Silikon meme protezlerinde ağrı, sertleşme, memede asimetriye yol açarak ikinci bir operasyona en sık yol açan komplikasyonlardan biri kapsül oluşumudur. Kapsül kontraktürü implant çevresindeki kollajenin yeniden organize edilmesi esnasında oluşur.Yara yüzeyinde kollajen birikimi oksijen basıncı ile ilişkilidir. Literatür tarandığında kapsül oluşumunu azaltmak amacıyla HBO tedavisine rastlanmamıştır. AMAÇ : HBO tedavisinin yara iyileşmesindeki olumlu etkilerinden yararlanılarak silikon etrafında oluşacak kapsül kalınlığının azaltılması ve böylelikle kapsülün olası olumsuz etkilerinin azaltılmasıdır. GEREÇ VE YÖNTEM : Toplam 60 rat 15'erli olmak üzere 4 gruba ayrılarak çalışmaya başlandı. Pürtüklü yüzeye sahip silikon meme implantı tüm ratların sırt bölgesine kas üstü ve kas altı plana yerleştirildi. Grup 3 ve 4'e postoperatif 1. günden başlanarak 15 gün boyunca günde 1 seans Hiperbarik Oksijen Tedavisi (HBOT) verildi. Postoperatif 60. günde tüm gruplarda silikon çevresinde gelişen kapsül kontraktürü incelenmek üzere çevresindeki kapsül alınarak histopatolojik incelemeye gönderildi. BULGULAR : Histopatolojik inceleme sonrası kapsül kalınlığı HBOT verilen grupların kontrol gruplarına göre oranı p < 0.0118 bulunarak anlamlı fark bulunmuştur. Ayrıca fibroblast ve nötrofil sayısı HBOT verilen grup 3 ve grup 4'de kontrol gruplarına göre istatistiksel olarak anlamlı şekilde düşük bulunmuştur. İncelenen kapsül yapısındaki neovaskülarizasyon oranlarına baktığımızda kontrol gruplarına göre HBOT verilen gruplarda anlamlı şekilde yüksek oran saptanmıştır. SONUÇ : Yaptığımız çalışmada HBOT verilen grup 3 ve 4 de kontrol gruplarına göre daha ince kapsül oluşumu gözlendi. İlerleyen çalışmalar gerekmekle birlikte meme augmentasyon yapılan hastalarda HBOT kapsül oluşumunu azaltabilir. Anahtar kelimeler: silikon, meme protezi, kapsül reaksiyonu, kapsül oluşumu, hiperbarik oksijen tedavisi
Silicone breast prostheses are frequently used in breast surgery. Causing pain, hardening and breast asymmetry capsule formation is one of the most common complications that give rise to a second operation in silicone breast prosthesis. Capsular contracture occurs during reorganization of the collagen around the implant. Collagen accumulation at the surface of a wound is related to oxygen pressure. There is no clinical or experimental study has been encountered demonstrating the effect of Hyperbaric Oxygen Therapy (HBOT) to reduce capsule formation around breast implant reviewing the literature. PURPOSE : This study aimed to decrease the possible negative effects of the capsule reducing thickness of it around the silicone based on the beneficial effects of HBOT on wound healing. MATERIALS AND METHODS : 60 rats were randomly divided into 4 equal groups , including 15 rats to each one. Silicone breast implants with rough surfaces were placed under and over the muscular plane in the back region of all rats. Starting from the first postoperative day, a HBOT session per day was given to Group 3 and 4 for 15 days. At the sixth postoperative day, capsules around the silicones were removed from all groups and sent to histopathological evaluation to examine the occurence of contracture, respectively. RESULTS : According to histopathological assessment, the ratio of capsular thickening in HBOT group to control group's was found as p <0.0118. Furthermore, fibroblast and neutrophil amounts in group 3 and group 4 rats had gotten HBOT treatment, were significantly less than control groups. Comparing to the control groups, neovascularization rate in capsular structure was exhibited excessively higher in HBOT-treated groups. CONCLUSION : In our study, thinner capsule formation was observed in HBOT- treated groups than control groups. Besides the requirement of progressive studies, HBOT can reduce the capsule formation around silicone prosthesis in patients with breast augmentation. Key words: silicone, breast prosthesis, capsule reaction, capsule formation, hyperbaric oxygen therapy
Silicone breast prostheses are frequently used in breast surgery. Causing pain, hardening and breast asymmetry capsule formation is one of the most common complications that give rise to a second operation in silicone breast prosthesis. Capsular contracture occurs during reorganization of the collagen around the implant. Collagen accumulation at the surface of a wound is related to oxygen pressure. There is no clinical or experimental study has been encountered demonstrating the effect of Hyperbaric Oxygen Therapy (HBOT) to reduce capsule formation around breast implant reviewing the literature. PURPOSE : This study aimed to decrease the possible negative effects of the capsule reducing thickness of it around the silicone based on the beneficial effects of HBOT on wound healing. MATERIALS AND METHODS : 60 rats were randomly divided into 4 equal groups , including 15 rats to each one. Silicone breast implants with rough surfaces were placed under and over the muscular plane in the back region of all rats. Starting from the first postoperative day, a HBOT session per day was given to Group 3 and 4 for 15 days. At the sixth postoperative day, capsules around the silicones were removed from all groups and sent to histopathological evaluation to examine the occurence of contracture, respectively. RESULTS : According to histopathological assessment, the ratio of capsular thickening in HBOT group to control group's was found as p <0.0118. Furthermore, fibroblast and neutrophil amounts in group 3 and group 4 rats had gotten HBOT treatment, were significantly less than control groups. Comparing to the control groups, neovascularization rate in capsular structure was exhibited excessively higher in HBOT-treated groups. CONCLUSION : In our study, thinner capsule formation was observed in HBOT- treated groups than control groups. Besides the requirement of progressive studies, HBOT can reduce the capsule formation around silicone prosthesis in patients with breast augmentation. Key words: silicone, breast prosthesis, capsule reaction, capsule formation, hyperbaric oxygen therapy
Açıklama
Anahtar Kelimeler
Hiperbarik oksijenasyon, Hyperbaric oxygenation, Histopatoloji, Histopathology, Komplikasyonlar, Complications
Kaynak
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Scopus Q Değeri
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Künye
Yarar, S. (2017). Hiperbarik oksijen tedavisinin silikon meme protez çevresinde kapsül oluşumu üzerine etkisinin histopatolojik olarak incelenmesi : Deneysel çalışma. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Plastik Cerrahi Anabilim Dalı, Konya.
