Doksorubisin ektravazasyonunda doksisiklinin etkisi
Küçük Resim Yok
Tarih
2007
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Ekstravazasyon özellikle kanser hastalarında sık görülmektedir. Sık kullanılan bir kemoterapi ajanı olan doksorubisinin ekstravazasyonu sonrası tam kat cilt nekrozu kanser hastalarının önemli morbidite kaynağıdır. Bu yaralanmalarda literatürde birçok tedavi seçenekleri önerilmesine rağmen, bu gibi lezyonların tedavisi hakkında tam bir tedavi protokolü oluşturulamamıştır. Bu çalışmanın amacı sıçan ekstravazasyon modelinde doksisiklin ile tedavinin etkilerini belirlemektir. Bu çalışmada 300-350 gr ağırlıklarında 40 Wistar-Albino sıçan kullanıldı. Sıçanlar 4 gruba ayrılarak, 3 gruba 30 mg/kg doksisiklin oral olarak uygulandı. Grup 1 (n=10): Hasardan 1 gün önce tedaviye başlandı. Grup 2 (n=10): Hasar ile aynı gün tedaviye başlandı. Grup 3 (n=10): Yaralanmadan sonraki gün tedaviye başlandı. Grup 4 (n=10): Kontrol grubu(tedavisiz). Enjeksiyon öncesi ketamin hydrochloride ve xylazine kullanılarak anestezi uygulandı. Sıçanların tümüne 1 mg doksorubisin, 1cc izotonik içinde intradermal olarak enjekte edildi. Yaralanmadan 7, 10, 12 ve 15 gün sonra injeksiyon yerinde ülser boyutu görüntü analiz programı ile ölçüldü. Onbeşinci günün sonunda biopsi materyali tüm nekrotik dokuları ve çevresindeki sağlıklı dokuyu içerecek şekilde elde edildi. Doku kesitleri histopatolojik olarak incelendi, komşu sağlam dokuda nötrofil sayımı yapıldı. Nekroz alanlarının ölçümünde Grup 1 ve 2' de nekroz boyutu kontrol grubu ile karşılaştırıldığında daha küçüktü ve bu istatistiksel olarak anlamlı idi. Grup 3' te ise nekroz boyutlarında kontrol grubu ile önemli derecede istatistiksel fark saptanmadı. Nötrofil sayımları Grup 1, 2 ve 3' te Grup 4 (kontrol)' e göre anlamlı olarak daha azdı. Bu veriler doksisiklinin doksorubisin ekstravazasyonu ile oluşan hasarı tedavi edici özelliği olduğunu ve ekstravazasyondan bir gün önce veya aynı gün verildiğinde daha efektif olduğunu göstermektedir. Anahtar kelimeler: ekstravazasyon, doksorubisin, doksisiklin, matriks metalloproteinaz
Extravasation injury is frequently seen particularly in cancer patients. Full-thickness skin necrosis after extravasation of the widely used chemotherapeutic agent doxorubicin is a significant source of morbidity in cancer patients. Although, various treatment options have been proposed for this type of injury, there is no consensus regarding the management of such lesions. The aim of this study was to determine the effectivity of doxycycline as a treatment in a rat extravasation model. Forty Wistar-Albino rats, weighing 300 to 350 g, were used in this study. The rats were divided to in four group and doxycycline 30 mg/kg/day was administred to three group via oral route between 0 and 15 days. Group 1 (n=10): One day before the injury they took treatment . Group 2 (n=10): Same time they took treatment whith injury . Group 3 (n=10): One day after the injury they took treatment. Group 4 (n=10): Control group (no treatment). The rats were anesthetized with ketamine hydrochloride and xylazine. All rats received a 1 mg of doxorubicin in 1 cc of saline via intradermal flank injection. At the end of seventh, tenth, twelfth and fifteenth days, the size of ulcers at the injection site were measured via image analysis program. A biopsy specimen, including necrotic tissue with adjacend healthy tissue, was obtained at the end of the fifteenth day. Biopsy specimens were evaluated histopatologically and neutrophil counts were obtained at the adjacent normal tissue. In group 1 and 2 there were statistically significant difference in the size of necrosis when compared with the control Group. There was no statistically significant difference in the size of necrosis in grup 3 when compared with the Group 4 (control). There was statistically significant difference in Groups 1, 2 and 3 the neutrophils counts when compared with Group 4 (control) . The data suggest that doxycyline more effective in treatment of doxorubicin injury when administered at the same day or the day before doxorubicin extravasation. Key words: extravasation, doxorubicin, doxycycline, matrix metalloproteinase
Extravasation injury is frequently seen particularly in cancer patients. Full-thickness skin necrosis after extravasation of the widely used chemotherapeutic agent doxorubicin is a significant source of morbidity in cancer patients. Although, various treatment options have been proposed for this type of injury, there is no consensus regarding the management of such lesions. The aim of this study was to determine the effectivity of doxycycline as a treatment in a rat extravasation model. Forty Wistar-Albino rats, weighing 300 to 350 g, were used in this study. The rats were divided to in four group and doxycycline 30 mg/kg/day was administred to three group via oral route between 0 and 15 days. Group 1 (n=10): One day before the injury they took treatment . Group 2 (n=10): Same time they took treatment whith injury . Group 3 (n=10): One day after the injury they took treatment. Group 4 (n=10): Control group (no treatment). The rats were anesthetized with ketamine hydrochloride and xylazine. All rats received a 1 mg of doxorubicin in 1 cc of saline via intradermal flank injection. At the end of seventh, tenth, twelfth and fifteenth days, the size of ulcers at the injection site were measured via image analysis program. A biopsy specimen, including necrotic tissue with adjacend healthy tissue, was obtained at the end of the fifteenth day. Biopsy specimens were evaluated histopatologically and neutrophil counts were obtained at the adjacent normal tissue. In group 1 and 2 there were statistically significant difference in the size of necrosis when compared with the control Group. There was no statistically significant difference in the size of necrosis in grup 3 when compared with the Group 4 (control). There was statistically significant difference in Groups 1, 2 and 3 the neutrophils counts when compared with Group 4 (control) . The data suggest that doxycyline more effective in treatment of doxorubicin injury when administered at the same day or the day before doxorubicin extravasation. Key words: extravasation, doxorubicin, doxycycline, matrix metalloproteinase
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Plastik ve Rekonstrüktif Cerrahi, Plastic and Reconstructive Surgery
