POSTOPERATÝF ABDOMÝNAL ADEZYONLARIN ÖNLENMESÝNDE STANDART HEPARÝN, DÜÞÜK MOLEKÜL AÐIRLIKLI HEPARÝN VE DEFÝBROTÝDE'ÝN KARÞILAÞTIRILMASI

Bu çalýþmada antitrombotik ve fibrinolitik özellikleri olan heparin,düþük molekül aðýrlýklý heparin ve defibrotide'in postoperatif adezyonlar üzerine etkileri araþtýrýldý. Herbiri 7 denekten oluþan 6 çalýþma ve bir kontrol grubundaki deneklere, adezyon oluþturmak için çekum serozasýna 1 cm. insizyon yapýldý ve parietal peritondan 1x 1 cm'lik alan çýkarýlarak oluþan defektler tek tek konulan 4/0 ipek sütürlerle onarýldý. Her 3 ajan intraperitoneal tek doz ve sübkütan 7 gün süreyle uygulandý. Sekizinci gün yapýlan relaparotomilerde adezyonlar makromorfolojik olarak deðerlendirildi. Cilt altý olarak heparin düþük molekül aðýrlýklý heparin ve defibrotide uygulanan gruplarda brid oluþumu kontrol grubuna göre anlamlý olarak daha az bulundu.(p< 0.01 ). Intraperitoneal olarak tek doz uygulanan gruplarda ise, kontrol grubuna göre anlamlýlýk saptanmadý. (p> 0.05).

THE EFFECTS OF HEPARIN, LOW MOLECULAR WEIGHT HEPARIN AND DEFIBROTIDE IN PREVENTION OF POSTOPERATIVE ABDOMINAL ADHESIONS

In this study, we investigated the effects of antitrombotic and fibrinolytic agents- heparine, low molecular weight heparine and defýbrotide on postoperative adhesions. In order to cause adhesion we made incision of 1 cm on ceacum serasa and excised a region of 1x1 cm peritoneum and repaired the defects with 4/0 separeted silk sutures. All 3 agents were given single intraperitoneal dose and 7 days subcuteneously form. Adhesions are assessed macromorphologically after relaparatomies made on the 8 day. Brids occured significantly less in groups that are given heparin, LMWH and defýbrotide subcuteneously compared to the control group, (p < 0.01). 0U groups that these agents were given intraperitoneally, there was no significant difference compared to the control group, (p > 0.05).