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An Experimental Study on the Effectiveness of Hyperbaric Oxygen and Thymoquinone Treatment in Blunt Duedonal Injury

Year 2018, Volume: 10 Issue: 3, 347 - 353, 23.10.2018
https://doi.org/10.18521/ktd.395839

Abstract

Objective: In duodenum injuries, despite being in a well-preserved area of abdomen, the duodenum is injured due to the presence of behind structures and good fixation lumbar vertebrae. HBO2 treatment reduces ischemia, one of the major causes of secondary damage. HBO2 treatment given serially after trauma, provide clinical, histopathological and biochemical recovery. Thymoquinone(TQ) has been shown to accelerate wound healing in topical or systemic use. We think that Grade 1-2 blunt duodenal traumas will benefit from HBO2 and oral TQ treatment.

Methods: 32 Wistar Albino rats were randomly assigned 4 groups. Surgical procedures were applied to rats outside Sham group. The first group was selected as sham, the second group was control, the third group was HBO2 treatment and the fourth group was HBO2 + TQ treatment. The results were examined histo-pathologically and biochemically in duodenum and serum.

Results: Therapy added TQ therapy increased the healing success while HBO2 treatment accelerated healing in histo-pathological findings. Although the parameters studied in the duodenum and serum were partially parallel to histo-pathologic changes, biochemical values were not found statistically significant in generally.

Conclusion: In this study, blunt trauma damage was simulated in the 2nd part of the duodenum. HBO2 and TQ treatment improved healing compared to the other groups in Grade 1-2 injuries. We believe that patients with Grade 1 and 2 duodenal injuries, if a successful HBO2 program and a treatment with TQ is added to the conservative therapy will benefit better than the existing treatment methods.

References

  • 1. Corley RD, Norcross WJ, Shoemaker WC. Traumatic injuries to the duodenum: a report of 98 patients. Ann Surg. 1975 Jan;181(1):92-8.
  • 2. Cerise EJ, Scully JH Jr. Blunt trauma to the small intestine. J Trauma. 1970 Jan;10(1):46-50.
  • 3. Rodriguez A, DuPriest RW Jr, Shatney CH. Recognition of intra-abdominal injury in blunt trauma victims. A prospective study comparing physical examination with peritoneal lavage. Am Surg. 1982 Sep;48(9):457-9.
  • 4. Schurink GW, Bode PJ, van Luijt PA, van Vugt AB. The value of physical examination in the diagnosis of patients with blunt abdominal trauma: a retrospective study. Injury. 1997 May;28(4):261-5.
  • 5. Moore EE, Cogbill TH, Malangoni MA, Jurkovich GJ, Champion HR et al. Organ injury scaling, II: Pancreas, duodenum, small bowel, colon, and rectum. J Trauma. 1990 Nov;30(11):1427-9.
  • 6. Peitzman AB, Makaroun MS, Slasky BS, Ritter P. Prospective study of computed tomography in initial management of blunt abdominal trauma. J Trauma. 1986 Jul;26(7):585-92.
  • 7. Allen GS, Moore FA, Cox CS Jr, Mehall JR, Duke JH. Delayed diagnosis of blunt duodenal injury: an avoidable complication. J Am Coll Surg. 1998 Oct;187(4):393-9.
  • 8. Méchine A, Rohr S, Toti F, Aysoy C, Schneider F et al. Wound healing and hyperbaric oxygen. Experimental study of the angiogenesis phase in the rat. Ann Chir. 1999;53(4):307-13.
  • 9. Yaman O, Yaman B, Aydın F, Var A, Temiz C. Hyperbaric oxygen treatment in the experimental spinal cord injury model. Spine J. 2014 Sep 1;14(9):2184-94.
  • 10. Hamzaoğlu I, Karahasanoğlu T, Aydin S, Sahin DA, Carkman S et al. The effects of hyperbaric oxygen on normal and ischemic colon anastomoses. Am J Surg. 1998 Nov;176(5):458-61.
  • 11. Adas M, Kemik O, Adas G, Arikan S, Kuntsal L et al. Is combined therapy more effective than growth hormone or hyperbaric oxygen alone in the healing of left ischemic and non-ischemic colonic anastomoses? Clinics (Sao Paulo). 2013 Nov;68(11):1440-5.
  • 12. Selçuk CT, Durgun M, Tekin R, Yolbas L, Bozkurt M et al. Evaluation of the Effect of Thymoquinone Treatment on Wound Healing in a Rat Burn Model. J Burn Care Res. 2013 Sep-Oct;34(5):e274-81.
  • 13. Al-Ali A, Alkhawajah AA, Randhawa MA, Shaikh NA. Oral and intraperitoneal LD50 of thymoquinone, an active principle of Nigella sativa, in mice and rats J Ayub Med Coll Abbottabad. 2008 Apr-Jun;20(2):25-7.
  • 14. Gutierrez IM, Mooney DP. Operative blunt duodenal injury in children: a multi-institutional review. J Pediatr Surg. 2012 Oct;47(10):1833-6.
  • 15. Hamilton A, Humphreys WG. Duodenal rupture complicating childhood non-accidental injury. Ulster Med J. 1985 Oct;54(2):221-3.
  • 16. Clendenon JN, Meyers RL, Nance ML, Scaife ER. Management of duodenal injuries in children. J Pediatr Surg. 2004 Jun;39(6):964-8.
  • 17. Bass D. Duodenal haematoma occurs in children with bicycle injuries. BMJ. 2001 Sep 29;323(7315):754-5.
  • 18. Champion MP, Richards CA, Boddy SA, Ward HC. Duodenal perforation: a diagnostic pitfall in non-accidental injury. Arch Dis Child. 2002 Nov;87(5):432-3.
  • 19. Carrillo EH, Richardson JD, Miller FB. Evolution in the management of duodenal injuries. J Trauma. 1996 Jun;40(6):1037-45; discussion 1045-6.
  • 20. Besselink MG, Berende NC, Preshaw RM, Romano C, Kortbeek J. Non-operative treatment of duodenal perforation secondary to blunt abdominal trauma. Injury. 2001 Jul;32(6):513-5.
  • 21. Peterson ML, Abbas PI, Fallon SC, Naik-Mathuria BJ, Rodriguez JR. Management of traumatic duodenal hematomas in children. J Surg Res. 2015 Nov;199(1):126-9.
  • 22. Gill AL, Bell CN. Hyperbaric oxygen: its uses, mechanisms of action and outcomes. QJM. 2004 Jul;97(7):385-95.
  • 23. Dockendorf BL, Frazee RC, Peterson WG, Myers D. Treatment of acute intestinal ischemia with hyperbaric oxygen. South Med J. 1993 May;86(5):518-20.
  • 24. Guimarães FA, Taha MO, Simões MJ, Fagundes DJ. Ischemia-Reperfusion of the Small Intestine and Hyperbaric Oxygen Treatment: A Morphologic Study in Rats. Transplant Proc. 2002 May;34(3):977-9.
  • 25. Guven A, Gundogdu G, Uysal B, Cermik H, Kul M et al. Hyperbaric oxygen therapy reduces the severity of necrotizing enterocolitis in a neonatal rat model. J Pediatr Surg. 2009 Mar;44(3):534-40.
  • 26. Kanter M, Demir H, Karakaya C, Ozbek H. Gastroprotective activity of Nigella sativa L oil and its constituent, thymoquinone against acute alcohol-induced gastric mucosal injury in rats. World J Gastroenterol. 2005 Nov 14;11(42):6662-6.
  • 27. Hosseinzadeh H, Parvardeh S, Asl MN, Sadeghnia HR, Ziaee T. Effect of thymoquinone and Nigella sativa seeds oil on lipid peroxidation level during global cerebral ischemia-reperfusion injury in rat hippocampus. Phytomedicine. 2007 Sep;14(9):621-7. Epub 2007 Feb 8.
  • 28. Kouidhi B, Zmantar T, Jrah H, Souiden Y, Chaieb K et al. Antibacterial and resistance- modifying activities of thymoquinone against oral pathogens. Ann Clin Microbiol Antimicrob. 2011 Jun 27;10:29.
  • 29. Selçuk CT, Durgun M, Tekin R, Yolbas L, Bozkurt M. Evaluation of the Effect of Thymoquinone Treatment on Wound Healing in a Rat Burn Model. J Burn Care Res. 2013 Sep-Oct;34(5):e274-81.
  • 30. Wang Y, Wang Y, Pang X, Du B, Li H et al. Ultrasensitive sandwich-type electrochemical immunosensor basedon dual signal amplification strategy using multifunctional graphenenanocomposites as labels for quantitative detection of tissuepolypeptide antigen. Sens. Actuat. B-Chem. 2015 Mar;214(1):124-31.
  • 31. Greenhalgh DG, Sprugel KH, Murray MJ, Ross R. PDGF and FGF stimulate wound healing in the genetically diabetic mouse. Am J Pathol. 1990 Jun;136(6):1235-46.

Deneysel Künt Duodenum Yaralanmalarında Hiperbarik Oksijen Tedavisi ve Timokinon’un Etkisi

Year 2018, Volume: 10 Issue: 3, 347 - 353, 23.10.2018
https://doi.org/10.18521/ktd.395839

Abstract

Amaç: Duodenumun abdomenin iyi korunmuş bir alanında olmasına rağmen, duodenum arkasında lomber vertebralar bulunmasından ve iyi fikse olmasından dolayı özellikle künt travmalarda yaralanabilmektedir. Hiperbarik Oksijen (HBO2) tedavisi, sekonder hasarın en önemli nedenlerinden biri olan iskemiyi azaltır. Travmadan sonra seri olarak verilen HBO2 tedavileri klinik, histopatolojik ve biyokimyasal fayda sağlar. Timokinon’un (TQ) topikal veya sistemik kullanımda yara iyileşmesini hızlandırdığı gösterilmiştir. Çalışmamızda deneysel oluşturulmuş Grade 1-2 künt duodenal travmalarda HBO2 ve oral TQ tedavisinin yararlı olabileceği yönünde sonuçlar elde edilmiştir.

Gereç ve Yöntem: 32 adet Wistar Albino cinsi rat rastgele 4 gruba ayıldı. Birinci grup dışındaki ratlara cerrahi işlem uygulanmıştır. İlk grup sham olarak seçilirken 2. grup kontrol, 3. grup HBO2 tedavisi, 4. grup ise HBO2+TQ tedavisi almıştır. Sonuçlar duodenum ve serumda histopatolojik ve biyokimyasal olarak incelenmiştir.

Bulgular: Histopatolojik bulgularda HBO2 tedavisi iyileşmeyi hızlandırırken tedaviye eklenen TQ tedavisi iyileşmedeki başarıyı artırmıştır. Duodenum dokusunda ve serumda çalışılan parametreler histopatolojik değişikliklere kısmen paralel olsa bile biyokimyasal değerler genel olarak istatistiksel olarak anlamlı bulunmamıştır.

Sonuç:  Bu çalışmada duodenumun 2. kısmına künt hasar taklit edilmiş ve HBO2 ve TQ tedavisinin Grade 1-2 hasarlarda diğer gruplara göre iyileşme sağladığı gösterilmiştir. Grade 1 ve 2 duodenal hasarlarda, konservatif tedavinin yanında belirlenecek bir HBO2 programı ve bu programa TQ eklenerek tedavide başarılı yanıtlar alınabileceğini düşünüyoruz.

References

  • 1. Corley RD, Norcross WJ, Shoemaker WC. Traumatic injuries to the duodenum: a report of 98 patients. Ann Surg. 1975 Jan;181(1):92-8.
  • 2. Cerise EJ, Scully JH Jr. Blunt trauma to the small intestine. J Trauma. 1970 Jan;10(1):46-50.
  • 3. Rodriguez A, DuPriest RW Jr, Shatney CH. Recognition of intra-abdominal injury in blunt trauma victims. A prospective study comparing physical examination with peritoneal lavage. Am Surg. 1982 Sep;48(9):457-9.
  • 4. Schurink GW, Bode PJ, van Luijt PA, van Vugt AB. The value of physical examination in the diagnosis of patients with blunt abdominal trauma: a retrospective study. Injury. 1997 May;28(4):261-5.
  • 5. Moore EE, Cogbill TH, Malangoni MA, Jurkovich GJ, Champion HR et al. Organ injury scaling, II: Pancreas, duodenum, small bowel, colon, and rectum. J Trauma. 1990 Nov;30(11):1427-9.
  • 6. Peitzman AB, Makaroun MS, Slasky BS, Ritter P. Prospective study of computed tomography in initial management of blunt abdominal trauma. J Trauma. 1986 Jul;26(7):585-92.
  • 7. Allen GS, Moore FA, Cox CS Jr, Mehall JR, Duke JH. Delayed diagnosis of blunt duodenal injury: an avoidable complication. J Am Coll Surg. 1998 Oct;187(4):393-9.
  • 8. Méchine A, Rohr S, Toti F, Aysoy C, Schneider F et al. Wound healing and hyperbaric oxygen. Experimental study of the angiogenesis phase in the rat. Ann Chir. 1999;53(4):307-13.
  • 9. Yaman O, Yaman B, Aydın F, Var A, Temiz C. Hyperbaric oxygen treatment in the experimental spinal cord injury model. Spine J. 2014 Sep 1;14(9):2184-94.
  • 10. Hamzaoğlu I, Karahasanoğlu T, Aydin S, Sahin DA, Carkman S et al. The effects of hyperbaric oxygen on normal and ischemic colon anastomoses. Am J Surg. 1998 Nov;176(5):458-61.
  • 11. Adas M, Kemik O, Adas G, Arikan S, Kuntsal L et al. Is combined therapy more effective than growth hormone or hyperbaric oxygen alone in the healing of left ischemic and non-ischemic colonic anastomoses? Clinics (Sao Paulo). 2013 Nov;68(11):1440-5.
  • 12. Selçuk CT, Durgun M, Tekin R, Yolbas L, Bozkurt M et al. Evaluation of the Effect of Thymoquinone Treatment on Wound Healing in a Rat Burn Model. J Burn Care Res. 2013 Sep-Oct;34(5):e274-81.
  • 13. Al-Ali A, Alkhawajah AA, Randhawa MA, Shaikh NA. Oral and intraperitoneal LD50 of thymoquinone, an active principle of Nigella sativa, in mice and rats J Ayub Med Coll Abbottabad. 2008 Apr-Jun;20(2):25-7.
  • 14. Gutierrez IM, Mooney DP. Operative blunt duodenal injury in children: a multi-institutional review. J Pediatr Surg. 2012 Oct;47(10):1833-6.
  • 15. Hamilton A, Humphreys WG. Duodenal rupture complicating childhood non-accidental injury. Ulster Med J. 1985 Oct;54(2):221-3.
  • 16. Clendenon JN, Meyers RL, Nance ML, Scaife ER. Management of duodenal injuries in children. J Pediatr Surg. 2004 Jun;39(6):964-8.
  • 17. Bass D. Duodenal haematoma occurs in children with bicycle injuries. BMJ. 2001 Sep 29;323(7315):754-5.
  • 18. Champion MP, Richards CA, Boddy SA, Ward HC. Duodenal perforation: a diagnostic pitfall in non-accidental injury. Arch Dis Child. 2002 Nov;87(5):432-3.
  • 19. Carrillo EH, Richardson JD, Miller FB. Evolution in the management of duodenal injuries. J Trauma. 1996 Jun;40(6):1037-45; discussion 1045-6.
  • 20. Besselink MG, Berende NC, Preshaw RM, Romano C, Kortbeek J. Non-operative treatment of duodenal perforation secondary to blunt abdominal trauma. Injury. 2001 Jul;32(6):513-5.
  • 21. Peterson ML, Abbas PI, Fallon SC, Naik-Mathuria BJ, Rodriguez JR. Management of traumatic duodenal hematomas in children. J Surg Res. 2015 Nov;199(1):126-9.
  • 22. Gill AL, Bell CN. Hyperbaric oxygen: its uses, mechanisms of action and outcomes. QJM. 2004 Jul;97(7):385-95.
  • 23. Dockendorf BL, Frazee RC, Peterson WG, Myers D. Treatment of acute intestinal ischemia with hyperbaric oxygen. South Med J. 1993 May;86(5):518-20.
  • 24. Guimarães FA, Taha MO, Simões MJ, Fagundes DJ. Ischemia-Reperfusion of the Small Intestine and Hyperbaric Oxygen Treatment: A Morphologic Study in Rats. Transplant Proc. 2002 May;34(3):977-9.
  • 25. Guven A, Gundogdu G, Uysal B, Cermik H, Kul M et al. Hyperbaric oxygen therapy reduces the severity of necrotizing enterocolitis in a neonatal rat model. J Pediatr Surg. 2009 Mar;44(3):534-40.
  • 26. Kanter M, Demir H, Karakaya C, Ozbek H. Gastroprotective activity of Nigella sativa L oil and its constituent, thymoquinone against acute alcohol-induced gastric mucosal injury in rats. World J Gastroenterol. 2005 Nov 14;11(42):6662-6.
  • 27. Hosseinzadeh H, Parvardeh S, Asl MN, Sadeghnia HR, Ziaee T. Effect of thymoquinone and Nigella sativa seeds oil on lipid peroxidation level during global cerebral ischemia-reperfusion injury in rat hippocampus. Phytomedicine. 2007 Sep;14(9):621-7. Epub 2007 Feb 8.
  • 28. Kouidhi B, Zmantar T, Jrah H, Souiden Y, Chaieb K et al. Antibacterial and resistance- modifying activities of thymoquinone against oral pathogens. Ann Clin Microbiol Antimicrob. 2011 Jun 27;10:29.
  • 29. Selçuk CT, Durgun M, Tekin R, Yolbas L, Bozkurt M. Evaluation of the Effect of Thymoquinone Treatment on Wound Healing in a Rat Burn Model. J Burn Care Res. 2013 Sep-Oct;34(5):e274-81.
  • 30. Wang Y, Wang Y, Pang X, Du B, Li H et al. Ultrasensitive sandwich-type electrochemical immunosensor basedon dual signal amplification strategy using multifunctional graphenenanocomposites as labels for quantitative detection of tissuepolypeptide antigen. Sens. Actuat. B-Chem. 2015 Mar;214(1):124-31.
  • 31. Greenhalgh DG, Sprugel KH, Murray MJ, Ross R. PDGF and FGF stimulate wound healing in the genetically diabetic mouse. Am J Pathol. 1990 Jun;136(6):1235-46.
There are 31 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Ali Erdal Güneş

Orhan Gözeneli This is me

Ali Akal This is me

Abdullah Taşkın This is me

Hatice Sezen This is me

Muhammed Emin Güldür

Publication Date October 23, 2018
Acceptance Date September 18, 2018
Published in Issue Year 2018 Volume: 10 Issue: 3

Cite

APA Güneş, A. E., Gözeneli, O., Akal, A., Taşkın, A., et al. (2018). Deneysel Künt Duodenum Yaralanmalarında Hiperbarik Oksijen Tedavisi ve Timokinon’un Etkisi. Konuralp Medical Journal, 10(3), 347-353. https://doi.org/10.18521/ktd.395839
AMA Güneş AE, Gözeneli O, Akal A, Taşkın A, Sezen H, Güldür ME. Deneysel Künt Duodenum Yaralanmalarında Hiperbarik Oksijen Tedavisi ve Timokinon’un Etkisi. Konuralp Medical Journal. October 2018;10(3):347-353. doi:10.18521/ktd.395839
Chicago Güneş, Ali Erdal, Orhan Gözeneli, Ali Akal, Abdullah Taşkın, Hatice Sezen, and Muhammed Emin Güldür. “Deneysel Künt Duodenum Yaralanmalarında Hiperbarik Oksijen Tedavisi Ve Timokinon’un Etkisi”. Konuralp Medical Journal 10, no. 3 (October 2018): 347-53. https://doi.org/10.18521/ktd.395839.
EndNote Güneş AE, Gözeneli O, Akal A, Taşkın A, Sezen H, Güldür ME (October 1, 2018) Deneysel Künt Duodenum Yaralanmalarında Hiperbarik Oksijen Tedavisi ve Timokinon’un Etkisi. Konuralp Medical Journal 10 3 347–353.
IEEE A. E. Güneş, O. Gözeneli, A. Akal, A. Taşkın, H. Sezen, and M. E. Güldür, “Deneysel Künt Duodenum Yaralanmalarında Hiperbarik Oksijen Tedavisi ve Timokinon’un Etkisi”, Konuralp Medical Journal, vol. 10, no. 3, pp. 347–353, 2018, doi: 10.18521/ktd.395839.
ISNAD Güneş, Ali Erdal et al. “Deneysel Künt Duodenum Yaralanmalarında Hiperbarik Oksijen Tedavisi Ve Timokinon’un Etkisi”. Konuralp Medical Journal 10/3 (October 2018), 347-353. https://doi.org/10.18521/ktd.395839.
JAMA Güneş AE, Gözeneli O, Akal A, Taşkın A, Sezen H, Güldür ME. Deneysel Künt Duodenum Yaralanmalarında Hiperbarik Oksijen Tedavisi ve Timokinon’un Etkisi. Konuralp Medical Journal. 2018;10:347–353.
MLA Güneş, Ali Erdal et al. “Deneysel Künt Duodenum Yaralanmalarında Hiperbarik Oksijen Tedavisi Ve Timokinon’un Etkisi”. Konuralp Medical Journal, vol. 10, no. 3, 2018, pp. 347-53, doi:10.18521/ktd.395839.
Vancouver Güneş AE, Gözeneli O, Akal A, Taşkın A, Sezen H, Güldür ME. Deneysel Künt Duodenum Yaralanmalarında Hiperbarik Oksijen Tedavisi ve Timokinon’un Etkisi. Konuralp Medical Journal. 2018;10(3):347-53.

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