Ulus Travma Acil Cerrahi Derg. 2016; 22(1): 7-11 | DOI: 10.5505/tjtes.2015.12612

Yað dokusundan elde edilmiþ stromal vasküler fraksiyonla doldurulmuþ ven greftleri ile periferik sinir kayýplarýnýn onarýmý: Deneysel çalýþma

Heval Selman Ozkan¹, Ozlem Karatas Silistreli², Bekir Ergur³, Saime Ýrkoren^1
1Adnan Menderes Üniversitesi Plastik Ve Rekonstruktif Cerrahisi Anabilim Dali
²Izmir Ataturk Egitim Ve Arastýrma Hastanesi Plastik Ve Rekonstruktif Cerrahisi Klinigi
³Dokuz Eylül Üniversitesi, Histoloji Embiroloji Anabilim Dalý Ýzmir

Amaç: Periferik sinir defektlerinin onarýmda ven greftleri ile beraber hücre kültürleri kullanýmý çalýþmalarý literatürde bulunmaktadýr. Yað dokusu kaynaklý kök hücrelerin periferik sinir iyileþmesini arttýrdýðýný gösteren çalýþmalar literatürde bulunmaktadýr. Bu nedenlerle periferik sinir defekti onarýmlarýnda ven grefti ve yað dokusu kaynaklý kök hücre kombine olarak kullanýmý etkilerini deðerlendirmek amacý ile sýçanlarda deneysel çalýþma uyguladýk.
Yöntem ve Gereç: Bunun için yaklaþýk 300gr aðýrlýðýnda 30 adet Wistar albino cinsi sýçan 3 çalýþma grubuna ayrýldý. Birinci cerrahi basamakta tüm hayvanlarýn sað tibial sinirlerinde yaklaþýk 8mm sinir defekti oluþturuldu. Grup 1’de (10 hayvan) otojensinir grefti kullanýldý. Grup 2’de (10 hayvan) içi boþ ven grefti ile, Grup 3’de (10 hayvan) ise ven grefti içine yað dokusu kaynaklý kök hücre doldurularak onarým uygulandý. Bu iþlemden 3 ay sonra çalýþmanýn ikinci cerrahi basamaðýnda hayvanlar sakrifiye edilerek onarým uygulanan sinir bölgesinden biyopsi alýndý. Alýnan örnekler ýþýk mikroskopu ile histopatolojik olarak deðerlendirildi.
Bulgular: Ýstatistiksel olarak gruplar arasýnda myelin ve akson çapý arasýnda anlamlý farklar yokken, akson sayýsý açýsýndan anlamlý farklar mevcuttu.
Sonuç: Sonuçlarýmýza göre periferik sinir kayýplarýnýn onarýmýnda SVF ve ven grefti kombinasyonu uygulanabilir bir seçenektir.

Anahtar Kelimeler: stromal vasküler fraksiyon, ven greft, sinir defekti, adipoz doku

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Repairing peripheral nerve defects by vein grafts filled with adipose tissue derived stromal vascular fraction: an experimental study in rats

Heval Selman Ozkan¹, Ozlem Karatas Silistreli², Bekir Ergur³, Saime Ýrkoren^1
1Adnan Menderes University, Department of plastic surgery, Aydin
²Izmýr Ataturk Training Research Hospital, Department of plastic surgery,Izmýr
³Dokuz Eylul University, Department of Embriology and Histology, Izmýr

Objectives: There are many studies in the literature combining vein grafts with cell cultures, muscle, tendon, nerve tissues but none of them could replaced isolated nerve grafts for nerve repair in clinical settings. There are studies in the literature indicating that adipose tissue derived stromal vascular fraction(SVF) enhances peripheral nerve healing. Considering these facts we performed an experimental study in rats based on combining SVF with vein grafts for peripheral nerve defect repairs.
Methods: We studied with 30 rats and produced 3 groups. In the first stage 8 mm nerve defect was created in tibial nerve of each rat. In group 1 defect was reconstructed with nerve graft, in group 2 defect was reconstructed with vein graft and in group 3 defect was reconstructed with vein graft filled with SVF solution. After 3 months, second surgical stage was performed and nerve biopsies were take. Tissue samples were observed histopathologically.
Results: Statistically there were no meaningful differance between nerve grafts, vein grafts and adipose tissue derived SVF- vein grafts combination groups considering myelin diameter, axonal diameter. Axon count was superior statisticcly in nerve graft and study group when compared empty vein groups.
Conclusion: Ýn conclusion, our results support usage of stromal vascular fraction-vein graft combination for peripheral nerve defect repairs.

Keywords: stromal vascular fraction, vein graft, nerve defect, adipose tissue

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