Sýçanlarda deneysel yanýk modelinde oluþan staz zonunda nitrogliserinin etkisi

AMAÇ: Yanýkta direkt termal etkiyle doku ölümü dýþýnda dermal vasküler oklüzyon ve akut tromboz görülür. Jackson tarafýndan termal yanýðýn baþlangýcýnda ortaya çýkan koagülasyon, staz ve hiperemi zonlarýnda oluþan yanýk modeli tariflenmiþtir. Bu çalýþmada antiiskemik ve vazodilatör etkinliði
olan %2 nitrogliserin staz bölgesine uygulanarak rutin tedavide kullanýlan gümüþ sulfadiyazin %1 krem ve basitrasin-neomisin pomad ile karþýlaþtýrýlarak yanýk tedavisinde etkinliði ve kullanýlabilirliðinin histomorfolojik ve immünhistokimyasal olarak deðerlendirilmesi amaçlandý.
GEREÇ VE YÖNTEM: Çalýþmamýzda beþ gruptan oluþan 30 adet sýçan kullanýldý. Grup 1; kontrol, 2; sham, 3; basitrasin-neomisin sülfat, 4; %2
nitrogliserin ve 5; gümüþ sülfadiazin %1 olarak oluþturuldu. ‘Comb’ yöntemiyle yanýk oluþturulup 0, 24 ve 48. saatlerde bu bölgelere lokal olarak
vazelin-lanolin, basitrasin-neomisin sülfat, %2 nitrogliserin ve gümüþ sülfadiazin %1 uygulanýp 72. saate patolojik deðerlendirme için biyopsi alýndý.
Alýnan materyaller uygun þekilde saklanýp histomorfolojik ve CD 34 ve D 2-40 immün boyalarý ile boyanarak vasküler ve lenfatik yapýlar immünohistokimyasal olarak deðerlendirildi.
BULGULAR: Histopatolojik incelemelerde %2 nitrogliserin uygulanan grupta diðer gruplarla karþýlaþtýrýldýðýnda ödem, enflamasyon ve vasküler
proliferasyonda istatistiksel olarak anlamlý artýþ saptandý.
TARTIÞMA: Ýskemik olan staz zonunda topikal %2 nitrogliserinin vasküler proliferasyonu artýrdýðý gözlenmiþ olup yanýk tedavisinde etkinliðinin olabileceði gösterilmiþtir

The effects of nitroglycerin in the zone of stasis in a rat burn model

BACKGROUND: Studies evaluating the recovery of the zone of stasis is an important issue in burn research. In this study, we aimed to evaluate and compare the efficiency of an anti-ischemic and vasodilatory agent, a topical agent containing 2% nitroglycerin with 1% silver sulfadiazine, and bacitracin-neomycin sulfate in the zone of stasis histomorphologically and immunohistochemically.
METHODS: We conducted an experimental study using 30 Wistar-Albino rats, each weighing 250–300 grams. The rats were divided randomly into five groups (six rats in each group). In this study, the “comb model,” which was deemed to be the most appropriate experimental model to produce an injury with predictable zones and was first described by Regas and Erhlich, was used. The following were applied to the zone of stasis after creating a burn model in 0, 24, and 48 hours: topical 2% nitroglycerin, 1% silver sulfadiazine, bacitracin-neomycin sulfate, and Vaseline-lanolin (sham). After 72 hours, biopsies were performed from the zone of stasis and evaluated by histomorphological and immunohistochemical CD 34 (expressed in human endothelial and hematopoietic cells) and D 2–40 (expressed in the endothelium of lymphatic capillaries) methods. The results were evaluated using the chi-square test.
RESULTS: Compared with the other groups, a statistically significant difference was found in edema, inflammation, and vascular proliferation in the nitroglycerin group. Significantly more intense staining for CD 34 was found in the nitroglycerin group compared with the other groups. Immunohistochemical staining for D 2-40 was also found statistically significant in the nitroglycerin group (p<0.05).
CONCLUSION: A topical containing 2% nitroglycerin increases vascular proliferation in the zone of stasis affects the recovery and may be used as a new agent in burn injury treatment.