Karatas A, Ozben V, Aytac E, Karaca F Can, Salihoglu Z, Uzun H, Erdamar S, Ulualp K
Department of General Surgery, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey.
Acta Chir Belg. 2012 Mar-Apr;112(2):121-5. doi: 10.1080/00015458.2012.11680809.
Among the various sutureless techniques, fibrin glue has proved to be effective in the treatment of peptic ulcer perforation as an alternative to classical suture repair. Albeit rare, a potential disadvantage of fibrin glue use is viral transmission or anaphylaxis. The aim of this study is to introduce a new technique for the closure of duodenal perforation using a novel recombinant enamel protein called amelogenin.
In this case-control experimental study, 32 adult male Wistar Albino rats weighing 250-300 g were randomly divided into four groups, each containing 8 rats. Duodenal perforation of 0.2 cm were performed in the postpyloric region in all rats. Each group received primary repair, primary repair with omentoplasty, fibrin glue, and amelogenin, respectively. All animals were killed on the postoperative day five and the bursting pressure measurements, hydroxyproline levels and histopathologic values of the wound site were evaluated.
Bursting pressure levels of the fibrin glue and amelogenin groups were significantly lower than the primary repair and primary repair with omentoplasty groups (P < 0.05) However, no significant difference existed between the fibrin glue and amelogenin groups in this respect (P > 0.05). There was also no statistically significant difference among all groups regarding tissue hydroxyproline levels and histopathologic values (P > 0.05).
Application of amelogenin as an alternative sutureless repair technique did not improve wound healing in this animal model of duodenal perforation.
在各种无缝合技术中，纤维蛋白胶已被证明可有效治疗消化性溃疡穿孔，作为经典缝合修复的替代方法。尽管罕见，但使用纤维蛋白胶的一个潜在缺点是病毒传播或过敏反应。本研究的目的是介绍一种使用名为釉原蛋白的新型重组釉质蛋白来闭合十二指肠穿孔的新技术。
在本病例对照实验研究中，将32只体重250 - 300克的成年雄性Wistar白化大鼠随机分为四组，每组8只。所有大鼠在幽门后区域进行0.2厘米的十二指肠穿孔。每组分别接受一期修复、一期修复加网膜成形术、纤维蛋白胶和釉原蛋白治疗。所有动物在术后第5天处死，评估伤口部位的破裂压力测量值、羟脯氨酸水平和组织病理学值。
纤维蛋白胶组和釉原蛋白组的破裂压力水平显著低于一期修复组和一期修复加网膜成形术组（P < 0.05）。然而，在这方面纤维蛋白胶组和釉原蛋白组之间没有显著差异（P > 0.05）。在组织羟脯氨酸水平和组织病理学值方面，所有组之间也没有统计学显著差异（P > 0.05）。
在这个十二指肠穿孔动物模型中，应用釉原蛋白作为一种替代无缝合修复技术并没有改善伤口愈合。
