Deneysel İkinci Derece Derin Yanık Modelinde Kültüre Edilmemiş Hücre Spreyi Kullanımı

Abstract

NURAL SK. The Use of Non-Cultured Cell Spray in Experimental Deep Second Degree Burn Model. Hacettepe University Faculty of Medicine, Thesis in General Surgery, Ankara 2019. Most of the burn injuries can be treated in outpatient clinics. Ten per cent of the burn patients need follow-up and treatment in a burn unit or center. The treatment process can sometimes be complicated and may result in sequelae / function loss. First and superficial second-degree burn wounds heals by wound care; Deep second and third degree burns require surgical treatment. In these patients, the closure of burn wounds with autograft use is the standard treatment method. However, due to problems such as long-term wound care, infection, donor site maintenance and complications, the search for ideal surgical treatment is in progress. Cultured epidermal autografts, although used for a while; failed to become an ideal wound treatment method. On the other hand, early autologous cell spray is thought to accelerate re-epithelization according to mesh graft. Thereafter, the use of non-cultured cell spray, which is based on keratinocyte isolation with the action of two-stage enzyme, can be applied more rapidly. The aim of this study was to establish the experimental model of the use of non-cultured cell spray in deep second-degree burns in rats and to compare the effectiveness of this method with the conventional partial-thickness skin graft. Twenty-four Wistar Albino rats were divided into 4 groups which were evaluated macroscopically and histologically on day 3,7,14 and 21 consecutively. Two deep second degree burns were created on the dorsal skin of the rats. On the 5 day a partial thickness skin graft was applied to one of the burn wounds after tangential excision. Two-stage enzyme was applied to the other half of the donor graft and keratinocytes were exposed. These cells were applied as a spray to the burn wound following tangential excision. After the procedure, the subjects were sacrificed on the 3rd, 7th, 14th and 21st days and their photographs were taken and tissue specimen were collected for histopathological examination. Non-epithelized area, inflammatory response and neovascularization were assessed histopathologically. The macroscopic examination performed by direct observation method, the take on rates were significantly better in the spray group. However, there was no statistically significant difference between the skin graft and the spray group in terms of inflammatory response and neovascularization in histopathological examination. In addition, a significant reverse correlation of medium strength was found between the percentage of macroscopic examination and non-epithelized area, inflammatory response and neovascularization. As a result of this study, it was found that the effect of cell autologous non-cultured cell spray on wound healing was similar the partial thickness skin grafting. The results show that the non-cultured cell spray method can be an effective graft method for the treatment of burns. However, there is a need for further studies to use this method in humans and to obtain clearer results. The animal model we described can be used for future research.