YARA ÝYÝLEÞMESÝ ÜZERÝNE KOLLAGENAZ'IN ETKÝSÝ

Bu çalýþma; son yýllarda yara bakýmýnda yaygýn olarak kullanýlmaya baþlanan enzim preparatlarýndan biri olan kollagenazýn yara iyileþmesi sürecine olan etkisini deðerlendirmek amacý ile, 15'erli iki gruba ayrýlan 30 adet rat kullanýlarak yapýldý. Kollagenazýn çalýþýldýðý grupta clostridium histolyticum kültür filtratýndan elde edilen clostridiopeptidaz-A ve eþlik eden proteazlar içeren pomad (NovuxoV) kullanýldý. Kontrol grubunda ise sadece serum fizyolojik kullanýldý. 48. saatte ve 7. günde yaralardan mikrobiyolojik kültür ve ek olarak yara kenarlarýndan histopatolojik inceleme için kesit alýndý. Histopatolojik kesitlerin deðerlendirilmesi ile elde edilen sonuçlar, yara iyileþmesi açýsýndan kollagenaz grubunun, kontrol grubuna göre belirgin olarak üstün olduðunu göstermektedir (p<0.005). Sadece neovaskülarizasyon ve hücre infiltrasyonu açýsýndan kollagenaz grubu ile kontrol grubu arasýnda istatistiksel olarak anlamlý fark bulunmadý. Ayrýca, enfeksiyonun kontrol grubunda kollagen yoðunluðu ve fibroblast aktivasyonunu anlamlý olarak azalttýðý (p<0.001), kollagenaz grubunda ise kollagen regülasyonunu belirgin olarak bozduðu belirlendi (p<0.001). Sonuç olarak, açýk yara tedavisinde kollagenaz kullanýmýnýn yara iyileþmesini hýzlandýrdýðý, kontrol grubuna göre belirgin olarak daha temiz ve canlý bir granülasyon dokusu saðladýðý, fibroblast ve myo fibroblast aktivasyonunu arttýrdýðý, kollagen liflerinde düzenli ve yoðun bir artýþa neden olduðu görülmektedir.

THE EFFECT OF COLLAGENASE IN WOUND HEALING

This study was planned for evaluating the effect of collagenase which is one of the popular enzyme used in wound healing recently. Two groups of rats which consist 15 animals each were used by this aim. On collagenase applied group Novuxol-as ointment- consist of the enzymes as protease and clostrodiopepsidase-A that is obtained from the culture filtrates of clostridium hystoliticum. In the control group serum physiologic was used. At second and seventh days samples were taken from the wound for microbiological and histopathological examinations. Histopathological examinations revealed that wound healing was better in the collagenase group than the control group (p<0.005). There were no significant difference about neovascularisation and cellular infiltration among the groups. It was seen that infection reduced the activation of fibroblasts and density of collagen's in control group (p<0.001) and impaired the regulation of collagen in collagenase treated group (p<0.001). As a result, we saw that treatment with collagenase accelerates healing in open wounds, supports a significantly clean and viable granulation tissue, increases activation of fibroblast and myofibroblast and results in a regular and dens increase in collagen fibrin's.