Deneysel Kronik Karaciğer Hastalığı Oluşturulan Sıçanlarda Sentetik Yama Kullanımının Cerrahi Alan Enfeksiyonu Üzerine Etkisi

Abstract

In patients with liver cirrhosis, the risk of infection that develops in the surgical field after usage of mesh for the anterior wall hernia repair of the abdomen, thus the risk of failure of the operation is still a matter of debate. The aim of this study is to investigate the relationship between the usage of mesh after creating abdominal hernia and the development of Staphylococcus aureus-induced mesh infection in the experimental cirrhosis model in rats. In the study, 4 groups were formed that 10 Wistar-Albino rats were included in each group. Cirrhosis was induced in the experimental groups (Group 1 and 2) by administrating intraperitoneal carbontetrachloride for 6 weeks. Then a mesh was replaced after creating hernia on the anterior wall of the abdomen and Staphylococcus aureus was inoculated onto the mesh in Group 2. In the control group (Group 3 and 4), without inducing cirrhosis, hernia was created on the anterior wall of the abdomen, then the hernia was repaired using a mesh, and Staphylococcus aureus was inoculated onto the mesh in Group 4. The rats were sacrificed after being observed for 14 days. Cultivation was done for quantitative microbiological evaluation after the mesh was removed. Biopsies were taken from the liver tissue of the rats in Groups 1 and 2. The removed meshes were evaluated in terms of bacterial load. As a result, an intense bacterial colonization (>105 cfu/cm2-7,5x104 cfu/cm2) was detected in the bacteria inoculated group 2 and 4, respectively. In group 1 (cirrhosis + mesh), the number of bacterial colonies was found to be 7.1x102 cfu/cm2, whereas minimal bacterial growth and minimal reproduction (1.7x101 cfu/cm2) was observed in group 3 (non-cirrhosis+mesh). The number of colonies in each of the 4 groups was found to be statistically significant (p <0.001). This study clearly demonstrates that the experimentally induced chronic liver disease prevented the bacterial clearence on the mesh used in hernia repair from diminishing.