Journals / Gülhane Tıp Dergisi / 1999 / Cilt: 41 - Sayı: 3
The effects of bi-drug chemotherapy protocol on perioperative wound healing
- Journal
- Gülhane Tıp Dergisi
- Pages
- 261–266
- DOI
- —
Abstract
This experimental study was performed to determine the most suitable usage time of cyclophos-phamide and adriamycin combination, frequently used chemotherapeutics on breast cancer, in terms of their effects on perioperative wound healing of rats. In this experimental study 240 rats, divided into 9 main groups according to the chemotheraphy administration days, were used. Under kethamine anesthesia for all rats an incision 3 centimeters in length including the skin, subcutaneus and panniculus carnosus layers at dorsal cervicothoracic region was performed in steril conditions and then immediately the incision line was sutured primarily. At previously planned days, therapeutic doses of cyclophosphamide and adriamycin combination and serum physiologic within the same volume as in the study groups were administered intraperitoneally in the study groups and in the control groups, respectively. Percentage of weight changing, hidroxyprolin levels, burst strength and histopatologic findings, were used to assess the effects of chemotherapeutics on wound healing. While a significant fall in hydroxiprolin levels, burst strength and a significant weight loss are observed for the groups in which chemoterapeutics were applied at preoperative 3 th and 1 th days, operation day, postoperative 1 th and 3 th days (P<0.05), the signs of inflamatuar phase are detected on histopatologic examination. On the other hand, there found some high values of weight gaining, hydroxyprolin levels and burst strength that do not effect the wound healing negatively for those groups in which chemotherapeutics were applied at preoperative 7 th day, postoperative 7 th and 14 th days and for the control groups that no chemotherapeutics were applied (p>0.05). An increase in fibroblastic and collagen activity was detected histopatologically. As a result, it is concluded that, the most suitable time periods for perioperative administration of chemotherapeutics in terms of wound healing rats are before and at preoperative 7 th days or after and at postoperative 7 th days. The usage of chemotherapeutics between these days seems to be very riskfull.
Özet
Meme kanserinde sık kullanılan kemoterapötik ajanlardan olan siklofosfamid ve adriyamisin kombinasyonunun, ratlarda perioperatif dönemde yara iyileşmesine etkileri deneysel çalışma ile araştırıldı. Çalışmada kemoterapi uygulama günlerine göre belirlenen 9 ana grup altında toplam 240 adet rat kullanıldı. Tüm ratlara ketamin anestezisi uygulanarak steril koşullarda dorsal servikotorasik alanlarında cilt, cilt altı ve pannikulus kamosusu kapsayan 3 cm'lik insizyon gerçekleştirilip hemen sonrasında primer sütürasyon uygulandı. Planlanan günlerde ratlara intraperitoneal olarak terapötik dozda siklofosfamid ve adriyamisin kombinasyonu, kontrol grubuna da aynı yolla ve eşit hacimde serum fizyolojik verildi. Yara iyileşmesinde kemoterapötik ajanların etkileri, ağırlık değişim yüzdeleri, hidroksiprolin değerleri, kopma direnci ölçümü ve histopatolojik inceleme ile araştırıldı. Preoperatif 3'üncü ve 1'inci günler, operasyon günü, postoperatif 1 'inci ve 3'üncü günler kemoterapi uygulanan gruplarda kilo kaybı, kopma direnci ve hidroksiprolin düzeylerinde anlamlı düşüş görülürken (p 0.05), histopatolojik olarak kollajen ve fibroblastik aktivitede artış saptandı. Sonuç olarak perioperatif dönemde ratlarda yara iyileşmesi açısından en uygun kemoterapi uygulama zamanının preoperatif 7. gün ve öncesi ya da postoperatif 7. gün ve sonrası olduğu, bu günler arasındaki kemoterapi uygulamalarının riskli olacağı kanısına varıldı.