Effect of Extractum cepae, heparin sodium and allantoin combination (contractubex) on adhesion and fibrosis after neck surgery (thyroidectomy) in rats

OBJECTIVE: Reoperative thyroid surgery is technically difficult process with increased complications due to the adhesions and fibrosis caused by the previous surgery. In this experimental animal model, we planned to investigate the effect of Contract Tubex tm, a mixture of Extractum Cepae, Heparin sodium and Allantoin, on adhesion and fibrosis after neck surgery (thyroidectomy).
METHODS: The current study is an experimental animal model of post-thyroidectomy adhesion. Twelve Wistar-Albino male rats in two groups were used. Under sterile conditions, a midline incision on the neck was made. The anterior thyroid muscles were separated and the thyroid lodge was reached. As a minor interventional procedure, a sponge was applied to the thyroid tissue, and then a combination of 1 g Extractum capae, heparin, sodium, and allantoin was applied to the dissection site in the drug group. Rats in both groups were sacrificed on 30th day. Cervical regions were dissected and evaluated for macroscopic adhesion. Tissue samples were taken for microscopic evaluation for fibrosis and inflammation.
RESULTS: In the experimental group in which ContractubexTM was applied, inflammation was not detected in five (83.3%) of six rats while no inflammation was detected in four (66.7%) of six rats in the control group (p=0.505). Considering the fibrosis score, mild or moderate fibrosis was detected in four (66.7%) of six rats in the control group, while fibrosis was found in only two (33.3%) rats in the experimental group (p=0.264). When macroscopic adhesion was evaluated, two (33.3%) rats of the control group subjects were Grade 4, and one (16.7%) was Grade 3. No rats in the experimental group were Grade 4 (p=0.392).
CONCLUSION: ContractubexTM seems to be effective in preventing adhesions and fibrosis after thyroidectomy and neck surgery, but further research is needed for use in human studies.

Sýçanlarda Boyun Cerrahisi (Tiroidektomi) Sonrasý Extractum Cepae, Heparin Sodyum ve Allantoin Kombinasyonunun (Contractubex) Yapýþýklýk ve Fibrozis Üzerine Etkisi

Re-operatif tiroid cerrahisi, önceki cerrahinin neden olduðu yapýþýklýklar ve fibrozis nedeniyle komplikasyonlarý yüksek ve teknik olarak zor bir süreçtir. Bu deneysel hayvan modelinde, Extractum Cepea, Heparin sodyum ve Allantoin karýþýmý olan Contract Tubex TM 'nin boyun cerrahisi (tiroidektomi) sonrasý geliþen adezyon ve fibrozis üzerine etkisini araþtýrmayý planladýk.
Yöntem:
Bu çalýþma, tiroidektomi sonrasý geliþen adezyonun deneysel bir hayvan modelidir. Ýki grupta 12 adet Wistar-Albino erkek rat kullanýldý. Steril koþullar altýnda boyunda orta hat kesi yapýldý. Ön tiroid kaslarý ayrýlarak tiroid lojuna ulaþýldý. Minör giriþimsel bir iþlem olarak tiroid dokusu spanç ile manipüle edildi ve ardýndan ilaç grubunda diseksiyon bölgesine 1 g Extractum capea, heparin, sodyum ve allantoin kombinasyonu uygulandý. Her iki gruptaki ratlar 30. günde sakrifiye edildi. Ratlarýn servikal bölgeleri diseke edildi ve makroskopik adezyon açýsýndan deðerlendirildi. Fibrozis ve inflamasyon oranlarýnýn mikroskobik deðerlendirmesi için doku örnekleri alýndý.
Bulgular:
ContractubexTM uygulanan deney grubunda altý ratýn beþinde (%83.3) inflamasyon saptanmazken, kontrol grubundaki altý ratýn dördünde (%66.7) inflamasyon saptanmadý (p=0.505). Fibrozis skoru dikkate alýndýðýnda, kontrol grubundaki altý ratýn dördünde (%66.7) hafif veya orta derecede fibrozis, deney grubunda ise sadece iki (%33.3) ratta fibrozis saptandý (p=0.264). Makroskopik adezyon deðerlendirildiðinde kontrol grubundaki deneklerden ikisinde (%33.3) grade 4, birin (%16.7) grade 3 adezyon tespit edildi. Deney grubundaki hiçbir sýçanda Grade 4adezyon izlenmedi (p=0,392).
Sonuç:
Contractubex TM, tiroidektomi ve boyun cerrahisi sonrasý geliþen yapýþýklýklarý ve fibrozisi önlemede etkili görünmektedir, ancak insan çalýþmalarýnda kullanýlmak üzere daha fazla araþtýrmaya ihtiyaç vardýr. (NCI-2021-7-3)