Sıçan modelinde erken dönem sinir onarımında yağ grefti kullanılmasının sinir iyileşmesi üzerine etkisinin incelenmesi
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Date
2015
Authors
Ersen, Burak
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Publisher
Uludağ Üniversitesi
Abstract
Periferik sinir kesisi onarımından sonra ideal sinir iyileşmesini sağlamak her zaman mümkün olmamaktadır. Sinir iyileşme kalitesini arttırmak için farklı cerrahi teknikler, malzemeler, çeşitli farmakolojik kimyasal ajanlar kullanılmıştır. Fakat sinir onarımı için mükemmel olarak tanımlayabileceğimiz bir yöntem hala bulunmamaktadır. Bu çalışmada, sıçan siyatik sinir kesisi onarım hattı çevresine sarılan yağ greftinin sinir iyileşmesi üzerine etkisinin incelenmesi amaçlandı. Bunun için, 24 adet Sprague-Dawley cinsi sıçan seçildi ve eşit 2 gruba ayrıldı. 12 sıçanın sağ gluteal bölgesinden yapılan insizyona gluteal kaslar arasından siyatik sinir açığa çıkarıldı. Sinir tam kat kesildikten sonra primer sinir onarımı aynı seansta yapıldı. Bu grup normal sinir iyileşme modeli olarak belirlendi. Diğer 12 sıçanda aynı şekilde siyatik sinir kesisi ve onarımı yapıldıktan sonra sağ poplitea posteriorundan alınan yağ grefti sinir hattı çevresine sarıldı. Bütün denekler 3.haftada sakrifiye edilerek sinir segmentleri çıkarıldı ve histopatolojik incelemeye gönderildi. Sonuç olarak çalışmada; Yağ grefti kullanımının erken dönem sinir onarımında sinir iyileşmesi üzerine makrofaj ve lenfosit infiltrasyonunu arttırarak olumlu etki yaptığı gözlemlendi.
Ideal neural healing is not always possible to establish after peripheral nerve repair. Various types of microsurgical tecniques, tools, pharmalogical and chemical agents were used to increase the quality of neural heliang process. However, there is still no technique available we consider as "perfect". In this study; it was aimed to investigate the effect of fat graft, wrapped around sciatic nerve repair coaptation zone, on neural healing. To establish this; twenty four Sprague-Dawley rats were chosen and seperated into two groups equally. In the first twelve rats, skin insicion was made on right gluteal area, after blunt muscle dissection sciatic nerve was exposed. Full thickness nerve cut was performed and primary nerve repair was also performed in the same session. First group was adressed as normal neural healing model. In the other twelve rats, same processes were performed in order to expose sciatic nerve. After nerve repair, fat graft harvested from right posterior popliteal area was wrapped around nerve coaptation zone. All the rats were sacrificed 3 weeks post-operatively, nerve segments were removed and sent for histopathological evaluation. As a result of this study; It was observed that wrapping fat graft around nerve coaptation zone had a pozitive effect on neural healing by increasing macophage and lymphocite infiltration to the repair zone.
Ideal neural healing is not always possible to establish after peripheral nerve repair. Various types of microsurgical tecniques, tools, pharmalogical and chemical agents were used to increase the quality of neural heliang process. However, there is still no technique available we consider as "perfect". In this study; it was aimed to investigate the effect of fat graft, wrapped around sciatic nerve repair coaptation zone, on neural healing. To establish this; twenty four Sprague-Dawley rats were chosen and seperated into two groups equally. In the first twelve rats, skin insicion was made on right gluteal area, after blunt muscle dissection sciatic nerve was exposed. Full thickness nerve cut was performed and primary nerve repair was also performed in the same session. First group was adressed as normal neural healing model. In the other twelve rats, same processes were performed in order to expose sciatic nerve. After nerve repair, fat graft harvested from right posterior popliteal area was wrapped around nerve coaptation zone. All the rats were sacrificed 3 weeks post-operatively, nerve segments were removed and sent for histopathological evaluation. As a result of this study; It was observed that wrapping fat graft around nerve coaptation zone had a pozitive effect on neural healing by increasing macophage and lymphocite infiltration to the repair zone.
Description
Keywords
Sinir iyileşmesi, Yağ grefti, Sinir onarımı, Neural healing, Fat graft, Nerve repair
Citation
Ersen, B. (2015). Sıçan modelinde erken dönem sinir onarımında yağ grefti kullanılmasının sinir iyileşmesi üzerine etkisinin incelenmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.