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Doku defektine sahip yaraların borik asit içeren poliüretan süngerle tedavisi (Randomize çalışma)

Yıl 2020, Cilt: 5 Sayı: 2, 83 - 90, 29.06.2020

Rana Kapukaya Özgür Külahçı

https://doi.org/10.30728/boron.650286

Öz

Günümüzde yara tedavisinde çok çeşitli yöntemler uygulanmasına rağmen henüz istenilen başarılar elde edilememiştir. Bugün için yara tedavisinde Negatif Basınçlı Yara Tedavi (NPWT) sisteminden başarılı sonuçlar alınmaktadır. Ancak bu sistemi oluşturan değişkenlerinde optimum değerlerde henüz ortak bir görüş yoktur. Biz bu çalışmada, halihazırda kullanılan gümüş nitrat yerine, borikasit kullanarak yaraları tedavi ettik. Doku defektli yaraya sahip hastalar, Ortopedi ve Travmatoloji kliniği ile Plastik ve Rekonstriktif Cerrahi kliniğinde borik asitli süngerler ile tedavi edildi. Yeni bir teknikle hazırlanmış bu süngerler negatif basınç üreten cihaz ile kombine (VAC) edilerek yaraların yüzeylerine uygulandı. Bu çalışmaya dahil edilen 129 hasta iki gruba bölündü. Her bir grup ise iki alt grupta incelendi. Birinci grupta (akut defektif yaraya sahip hastalar) bulunan 49 hastanın 22’sine gümüş nitratlı sünger, 27’sine ise borik asit parçacıklı süngerler kullanıldı. İkinci grupta (kronik defektif yaraya sahip hastalar) bulunan 80 hastanın 36’sına gümüş nitratlı 44’üne ise borik asit parçacıklı süngerler kullanıldı. Birinci grupta borik asitli sünger uygulanan hastaların yaş ortalaması 34,25±8,89, yara boyutu 79,26±26,04 mm idi. Gümüşlü sünger kullanan grupta ise yaş ortalaması 32,85±10,95 yıl, yara boyutu ise 85,91±26,53 mm idi. İkinci grupta ise borik asitli sünger kullanan grupta hastaların yaş ortalaması 63.76±11.94 yıl idi. Yara boyutu ise ortalama 85,26±25.40 mm idi. Gümüşlü sünger kullanan grupta ise hastaların yaş ortalaması 64,16±10,12 yıl idi. Yara boyutu ise ortalama 85,91±26,53 mm idi. Her iki grubun alt grupları arasında cinsiyet, genel alışkanlıkları, yaş ve yara boyutu ve lokalizasyonun bakımından anlamlı bir fark yoktu. Bu çalışmada borik asit parçacıklı sünger kullanılan her yaranın bütün evrelerinde kısalmalar tespit edilmiş ve biyopsilerin histopatolojik incelemelerinde özellikle 10. günden itibaren inflamatuar, granülasyon angiogenesis ve epitelizasyon fazlarında anlamlı bir farkın olduğu tespit edilmiştir. Sonuç olarak yaranın hem klinik özellikleri, hem de histopatolojik sonuçları dikkate alındığında asit borikli süngerlerin, yaranın her evresinde gümüşlü süngere kıyasla daha üstün bir etkiye sahip olduğu tespit edildi.

Anahtar Kelimeler

Borik Asit Poliüretan sünger Yara iyileşmesi

Destekleyen Kurum

YOK

Proje Numarası

57

Teşekkür

PROF.DR.AHMET KAPUKAYA

Kaynakça

  • [1] Huang C., Leavitt T., Bayer L. R., Orgil D. P., Effect of negative pressure wound therapy on wound healing, Current Problems in Surgery. 51 (7), 301-31, 2014.
  • [2] Putnis S., Khan W. S., Wong J. M. L., Negative pressure wound therapy – A review of its uses in orthopaedic trauma, Open Orthop, J., 8, 142-147, 2014.
  • [3] Orgill D. P., Manders E. K., Sumpio B.E., Lee R. C., Attinger C. E., Gurtner G. C., Ehrlich H. P., The mechanisms of action of vacuum assisted closure: More to learn, Surgery, 146 (1), 40-51, 2009.
  • [4] Gaisford S., Beezer A. E., Bishop A. H., Walker M., Parsons D., An in vitro method for the quantitative determination of the antimicrobial efficacy of silver-containing wound dressings, Int. J. Pharm., 336 (1-2), 111-6, 2008.
  • [5] Sigel H. J., Herrera D. F. Silver negative pressure dressing with vacuum-assisted closure of massive pelvic and extremity wounds, Clin. Orthop. Relat. Res. 472, 830–835, 2014.
  • [6] McDonnell G., Russell A. D., Antiseptics and disinfectants: Activity, action, and resistance, Clin. Microbiol. Rev., 12 (1), 147-179, 1999.
  • [7] Borrelly J., Blench M. F., Grosdidier G., Martin T. C., Haertemann P., Contribution of a 3% solution of boric acid in the treatment of deep wounds with loss of substance, Ann Chir Plast Esthet. 36 (1), 65-9, 1991.
  • [8] Tepedelen B. E., Soya E., Korkmaz M., Boric acid reduces the formation of DNA double strand breaks and accelerates wound healing process, Biol. Trace Elem. Res., 174 (2), 309-318, 2016.
  • [9] Nzietchueng R. M., Dousset B., Franck P., Benderdour M., Nabet P., Hess K., Mechanisms implicated in the effects of boron on wound healing, J. Trace Elem. Med. Biol., 16 (4), 239-44, 2002.
  • [10] Bickers D. R , Lim H. W., Margolis D., Weinstock M. A., Goodman C., Faulkner E., Gould C., et al., The burden of skin diseases: 2004 a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology, J. Am. Acad. Dermatol., 55, 490-500, 2006.
  • [11] Hopman W. M., Harrison M. B., Coo H., Friedberg E., Buchanan M., VanDenKerkhof E. G., Associations between chronic disease, age and physical and mental health status, Chronic Dis. Can., 29, 108-116, 2009.
  • [12] Armstrong D. G., Wrobel J., Robbins J. M., Guest Editorial: are diabetes-related wounds and amputations worse than cancer? Int. Wound J., 4:286-287, 2007.
  • [13] Orgill D. P., Manders E. K., Sumpio B. E., Lee R. C., Attinger C. E., Gurtner G. C., et al., The mechanisms of action of vacuum assisted closure: More to learn, Surgery, 146 (1), 40–51, 2009.
  • [14] Scherer S. S., Pietramaggiori G., Mathews J. C., Prsa M. J., Huang S., Orgill D. P., The mechanism of action of the vacuum-assisted closure device, Plast. Reconstr. Surg., 122 (3), 786–797, 2008.
  • [15] Ingber D. E., The mechanochemical basis of cell and tissue regulation, Mech. Chem. Biosyst., 1 (1), 53–68, 2004.
  • [16] Scherer S., Pietramaggiori G., Mathews J., Prsa M. J., Huang S., Orgill D. P., The mechanism of action of the vacuum assisted closure device, Plast. Reconstr. Surg., 122, 786-97, 2008.
  • [17] Sudmann E., Vik H., Rait M., Todnem K., Andersen K. J., Julsham K., et al. Systemic and local silver accumulation after total hip replacement using silver-impregnated bone cement, Med. Prog. Technol., 20, 179–84, 1994.
  • [18] Trop M., Novak M., Rodl S., Hellbom B., Silver-coated dressing acticoat caused raised liver enzymes and argyria-like symptoms in burn patient, J. Trauma, 60 (3), 648-52, 2006.
  • [19] Chung I. S., Lee M. Y., Shin D. H., Jung H. R., Three systemic argyria cases after ingestion of colloidal silver solution, Int. J. Dermatol. 49, 1175–1177, 2010.
  • [20] Wan A. T., Conyers R. A., Coombs C. J., Masterton J. P., Determination of silver in blood, urine, and tissues of volunteers and burn patients, Clin. Chem., 37, 1683–1687, 1991.
  • [21] Drake P. L., Hazelwood K. J., Exposure-related health effects of silver and silver compounds: A review, Ann. Occup. Hyg., 49, 575–585, 2005.
  • [22] Samman S., Foster M., Hunter D., The role of boron in human nutrition and metabolism, CRC Press, New York, 2011.
  • [23] Borrelly J., Blech M., Grosdidier G., Martin-Thomas C., Hartemann P., Contribution of a 3% solution of boric acid in the treatment of deep wounds with loss of substance, Ann. Chir. Plast. Esthet., 36:65–69, 1990.
  • [24] Nzietchueng R. M., Dousset B., Franck P., Benderdour M., Nabet P., Hess K., Mechanisms implicated in the effects of boron on wound healing, J. Trace Elem. Med. Biol., 16 (4), 239–244, 2002
  • [25] Chebassier N., Ouijja E. H., Viegas I., Dreno B. Stimulatory effect of boron and manganese salts on keratinocyte migration. Acta Derm Venereol 84:191–194, 2004.
  • [26] Doğan A., Demirci S., Cağlayan A. B., Kılıç E., Günal M.Y., Uslu U., Cumbul A., Şahin F., Sodium pentaborate pentahydrate and pluronic containing hydrogel increases cutaneous wound healing in vitro and in vivo, Biol. Trace Elem. Res. 162, 72–79, 2014.
  • [27] Demirci S., Doğan A., Karakuş E., Halıcı Z., Topçu A., Demirci E., Şahin F, Boron and poloxamer (F68 and F127) containing hydrogel formulation for burn wound healing, Biol. Trace Elem. Res. 168, 169–180, 2015.
  • [28] Özcan K. M., Sitesi Y., Blok A., The efficacy of boric acid in otomycosis: An in vitro study, Mediter. J. Otol. 2,1–4, 2005.
  • [29] Yilmaz M.T., Minimum inhibitory and minimum bactericidal concentrations of boron compounds against several bacterial strains. Turk J. Med. Sci. 42,1423–1429, 2012.
  • [30] Jacobs S., Simhaee D. A., Marsano A., Fomovsky G. M., Niedt G., Wu J. K., Efficacy and mechanisms of vacuum-assisted closure (VAC) therapy in promoting wound healing: A rodent model, JPRAS, 62 (10), 1331-1338, 2009.
  • [31] Eginton M. T., Brown K. R., Seabrook G. R., Towne J. B., Cambria R.A., A prospective randomized evaluation of negative-pressure wound dressings for diabetic foot wounds, Ann. Vasc. Surg. 17, 645-9, 2003.
  • [32] Yusuf E., Jordan X., Clauss M., Borens O., Mader M., Trampuz A., High bacterial loadin negative pressure wound therapy (NPWT) foam susedin the treatment of chronic wounds, Wound Repair Regen., 21 (5), 677–68, 2013.
  • [33] Joseph E., Hamori C. A., Bergman S., Roaf E., Swann N. F., Anastasi G. W., A prospective, randomized trial of vacuum-assisted closure versus standard therapy of chronic nonhealing wounds, Wounds, 12, 60–67, 2000.

Treatment of tissue defect wounds with boric acid polyurethane sponge (Randomized study)

Yıl 2020, Cilt: 5 Sayı: 2, 83 - 90, 29.06.2020

Rana Kapukaya Özgür Külahçı

https://doi.org/10.30728/boron.650286

Öz

Today, despite the application of various methods in wound treatment, the desired success has not been achieved yet. Today, successful results are obtained in Negative Pressure Wound Treatment (NPWT) system for wound treatment. However, there is no consensus on the optimum values of the variables that comprise this system. In this study, we treated wounds by using boric acid instead of silver nitrate that is currently used. Patients with tissue defect wounds were treated with sponges with boric acid in the Orthopedics and Traumatology Clinic and the Plastic and Reconstructive Surgery Clinic. Prepared with a new technique, these sponges were combined with negative pressure generating device (VAC) and applied to the surfaces of the wounds. 129 patients included in this study were divided into two groups. Each group was examined in two subgroups. Of the 49 patients in the first group (patients with acute defective wounds), 22 had silver nitrate sponges and 27 had boric acid sponges. Of the 80 patients in the second group (patients with chronic defective wounds), 36 used silver nitrate and 44 used boric acid sponges. In the first group, the mean age of the patients who were treated with boric acid sponge was 34.25 ± 8.89 and the wound size was 79.26 ± 26.04 mm. The mean age was 32.85 ± 10.95 years and the size of the wound was 85.91 ± 26.53 mm. In the second group, the mean age of the patients using the sponge with boric acid was 63.76 ± 11.94 years. The mean wound size was 85.26 ± 25.40 mm. In the silver sponge group, the mean age of the patients was 64.16 ± 10.12 years. The mean wound size was 85.91 ± 26.53 mm. There was no significant difference between the two groups in terms of gender, general habits, age and wound size and localization. In this study, shortening was determined in all stages of each wound using boric acid sponge and histopathological examination of biopsies revealed a significant difference especially in inflammatory, granulation angiogenesis and epithelization phases from day 10 onwards. As a result, considering both the clinical features and histopathological results of the wound, it was found that acid boric sponges had a superior effect at each stage of the wound compared to silver sponge.

Anahtar Kelimeler

Boric acid Polyurethane sponge Wound healing

Proje Numarası

57

Kaynakça

  • [1] Huang C., Leavitt T., Bayer L. R., Orgil D. P., Effect of negative pressure wound therapy on wound healing, Current Problems in Surgery. 51 (7), 301-31, 2014.
  • [2] Putnis S., Khan W. S., Wong J. M. L., Negative pressure wound therapy – A review of its uses in orthopaedic trauma, Open Orthop, J., 8, 142-147, 2014.
  • [3] Orgill D. P., Manders E. K., Sumpio B.E., Lee R. C., Attinger C. E., Gurtner G. C., Ehrlich H. P., The mechanisms of action of vacuum assisted closure: More to learn, Surgery, 146 (1), 40-51, 2009.
  • [4] Gaisford S., Beezer A. E., Bishop A. H., Walker M., Parsons D., An in vitro method for the quantitative determination of the antimicrobial efficacy of silver-containing wound dressings, Int. J. Pharm., 336 (1-2), 111-6, 2008.
  • [5] Sigel H. J., Herrera D. F. Silver negative pressure dressing with vacuum-assisted closure of massive pelvic and extremity wounds, Clin. Orthop. Relat. Res. 472, 830–835, 2014.
  • [6] McDonnell G., Russell A. D., Antiseptics and disinfectants: Activity, action, and resistance, Clin. Microbiol. Rev., 12 (1), 147-179, 1999.
  • [7] Borrelly J., Blench M. F., Grosdidier G., Martin T. C., Haertemann P., Contribution of a 3% solution of boric acid in the treatment of deep wounds with loss of substance, Ann Chir Plast Esthet. 36 (1), 65-9, 1991.
  • [8] Tepedelen B. E., Soya E., Korkmaz M., Boric acid reduces the formation of DNA double strand breaks and accelerates wound healing process, Biol. Trace Elem. Res., 174 (2), 309-318, 2016.
  • [9] Nzietchueng R. M., Dousset B., Franck P., Benderdour M., Nabet P., Hess K., Mechanisms implicated in the effects of boron on wound healing, J. Trace Elem. Med. Biol., 16 (4), 239-44, 2002.
  • [10] Bickers D. R , Lim H. W., Margolis D., Weinstock M. A., Goodman C., Faulkner E., Gould C., et al., The burden of skin diseases: 2004 a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology, J. Am. Acad. Dermatol., 55, 490-500, 2006.
  • [11] Hopman W. M., Harrison M. B., Coo H., Friedberg E., Buchanan M., VanDenKerkhof E. G., Associations between chronic disease, age and physical and mental health status, Chronic Dis. Can., 29, 108-116, 2009.
  • [12] Armstrong D. G., Wrobel J., Robbins J. M., Guest Editorial: are diabetes-related wounds and amputations worse than cancer? Int. Wound J., 4:286-287, 2007.
  • [13] Orgill D. P., Manders E. K., Sumpio B. E., Lee R. C., Attinger C. E., Gurtner G. C., et al., The mechanisms of action of vacuum assisted closure: More to learn, Surgery, 146 (1), 40–51, 2009.
  • [14] Scherer S. S., Pietramaggiori G., Mathews J. C., Prsa M. J., Huang S., Orgill D. P., The mechanism of action of the vacuum-assisted closure device, Plast. Reconstr. Surg., 122 (3), 786–797, 2008.
  • [15] Ingber D. E., The mechanochemical basis of cell and tissue regulation, Mech. Chem. Biosyst., 1 (1), 53–68, 2004.
  • [16] Scherer S., Pietramaggiori G., Mathews J., Prsa M. J., Huang S., Orgill D. P., The mechanism of action of the vacuum assisted closure device, Plast. Reconstr. Surg., 122, 786-97, 2008.
  • [17] Sudmann E., Vik H., Rait M., Todnem K., Andersen K. J., Julsham K., et al. Systemic and local silver accumulation after total hip replacement using silver-impregnated bone cement, Med. Prog. Technol., 20, 179–84, 1994.
  • [18] Trop M., Novak M., Rodl S., Hellbom B., Silver-coated dressing acticoat caused raised liver enzymes and argyria-like symptoms in burn patient, J. Trauma, 60 (3), 648-52, 2006.
  • [19] Chung I. S., Lee M. Y., Shin D. H., Jung H. R., Three systemic argyria cases after ingestion of colloidal silver solution, Int. J. Dermatol. 49, 1175–1177, 2010.
  • [20] Wan A. T., Conyers R. A., Coombs C. J., Masterton J. P., Determination of silver in blood, urine, and tissues of volunteers and burn patients, Clin. Chem., 37, 1683–1687, 1991.
  • [21] Drake P. L., Hazelwood K. J., Exposure-related health effects of silver and silver compounds: A review, Ann. Occup. Hyg., 49, 575–585, 2005.
  • [22] Samman S., Foster M., Hunter D., The role of boron in human nutrition and metabolism, CRC Press, New York, 2011.
  • [23] Borrelly J., Blech M., Grosdidier G., Martin-Thomas C., Hartemann P., Contribution of a 3% solution of boric acid in the treatment of deep wounds with loss of substance, Ann. Chir. Plast. Esthet., 36:65–69, 1990.
  • [24] Nzietchueng R. M., Dousset B., Franck P., Benderdour M., Nabet P., Hess K., Mechanisms implicated in the effects of boron on wound healing, J. Trace Elem. Med. Biol., 16 (4), 239–244, 2002
  • [25] Chebassier N., Ouijja E. H., Viegas I., Dreno B. Stimulatory effect of boron and manganese salts on keratinocyte migration. Acta Derm Venereol 84:191–194, 2004.
  • [26] Doğan A., Demirci S., Cağlayan A. B., Kılıç E., Günal M.Y., Uslu U., Cumbul A., Şahin F., Sodium pentaborate pentahydrate and pluronic containing hydrogel increases cutaneous wound healing in vitro and in vivo, Biol. Trace Elem. Res. 162, 72–79, 2014.
  • [27] Demirci S., Doğan A., Karakuş E., Halıcı Z., Topçu A., Demirci E., Şahin F, Boron and poloxamer (F68 and F127) containing hydrogel formulation for burn wound healing, Biol. Trace Elem. Res. 168, 169–180, 2015.
  • [28] Özcan K. M., Sitesi Y., Blok A., The efficacy of boric acid in otomycosis: An in vitro study, Mediter. J. Otol. 2,1–4, 2005.
  • [29] Yilmaz M.T., Minimum inhibitory and minimum bactericidal concentrations of boron compounds against several bacterial strains. Turk J. Med. Sci. 42,1423–1429, 2012.
  • [30] Jacobs S., Simhaee D. A., Marsano A., Fomovsky G. M., Niedt G., Wu J. K., Efficacy and mechanisms of vacuum-assisted closure (VAC) therapy in promoting wound healing: A rodent model, JPRAS, 62 (10), 1331-1338, 2009.
  • [31] Eginton M. T., Brown K. R., Seabrook G. R., Towne J. B., Cambria R.A., A prospective randomized evaluation of negative-pressure wound dressings for diabetic foot wounds, Ann. Vasc. Surg. 17, 645-9, 2003.
  • [32] Yusuf E., Jordan X., Clauss M., Borens O., Mader M., Trampuz A., High bacterial loadin negative pressure wound therapy (NPWT) foam susedin the treatment of chronic wounds, Wound Repair Regen., 21 (5), 677–68, 2013.
  • [33] Joseph E., Hamori C. A., Bergman S., Roaf E., Swann N. F., Anastasi G. W., A prospective, randomized trial of vacuum-assisted closure versus standard therapy of chronic nonhealing wounds, Wounds, 12, 60–67, 2000.
Toplam 33 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Mühendislik
Bölüm Research Makaleler
Yazarlar

Rana Kapukaya 0000-0001-9709-328X

Özgür Külahçı Bu kişi benim

Proje Numarası 57
Yayımlanma Tarihi 29 Haziran 2020
Kabul Tarihi 27 Mayıs 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 5 Sayı: 2

Kaynak Göster

APA Kapukaya, R., & Külahçı, Ö. (2020). Doku defektine sahip yaraların borik asit içeren poliüretan süngerle tedavisi (Randomize çalışma). Journal of Boron, 5(2), 83-90. https://doi.org/10.30728/boron.650286

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