Is gentamicin-impregnated collagen sponge to be recommended in pilonidal sinus patient treated with marsupialization? A prospective randomized study.

BACKGROUND: The ideal treatment method for pilonidal sinus has always been a matter of debate. Although primary closure or various flap applications offer shorter wound healing times, their infection rates are very high. Secondary recovery involves long recovery period. The aim of this study is to investigate the effects of gentamicin-impregnated collagen sponge on wound healing and infection in patients undergoing marsupialization. PATIENTS AND METHODS: Fifty patients were included in the study. Twenty-five patients in control group (Group 1) underwent excision and marsupialization. Gentamicin-impregnated collagen sponge was used postoperatively in twentyfive patients in group 2. Three-dimensional wound measurements were made on the 0.7 and 15th days and recorded. RESULTS: No significant difference was observed between the groups in terms of development of hemorrhage and infection. Excessive granulation was detected in five patients (two in group 1 and three in group 2). There was no significant difference between the groups with respect to this criterion. Full recovery times were 29.6 and 28.2 days respectively. No statistically significant difference was observed between the groups (p = 0.571). None of the patients developed recurrence at the end of the follow-up period of 6-30 months. CONCLUSION: In accordance with the results obtained in this randomized and controlled study, no significant difference was observed between gentamicin-impregnated collagen sponge group and control group with respect to development of infection, hemorrhage and wound healing times. Therefore, we do not recommend the use of gentamicin-impregnated collagen sponge after marsupialization. KEY WORDS: Gentamicin-impregnated collagen sponge, Marsupialization, Pilonidal sinus.

The protective effect of diosmin on hepatic ischemia reperfusion injury: an experimental study.

Liver ischemia reperfusion injury (IRI) is an important pathologic process leading to bodily systemic effects and liver injury. Our study aimed to investigate the protective effects of diosmin, a phlebotrophic drug with antioxidant and anti-inflammatory effects, in a liver IRI model. Forty rats were divided into 4 groups. Sham group, control group (ischemia-reperfusion), intraoperative treatment group, and preoperative treatment group. Ischemia reperfusion model was formed by clamping hepatic pedicle for a 60 minute of ischemia followed by liver reperfusion for another 90 minutes. Superoxide dismutase (SOD) and catalase (CAT) were measured as antioaxidant enzymes in the liver tissues, and malondialdehyde (MDA) as oxidative stress marker, xanthine oxidase (XO) as an oxidant enzyme and glutathione peroxidase (GSH-Px) as antioaxidant enzyme were measured in the liver tissues and the plasma samples. Hepatic function tests were lower in treatment groups than control group (p<0.001 for ALT and AST). Plasma XO and MDA levels were lower in treatment groups than control group, but plasma GSH-Px levels were higher (p<0.05 for all). Tissue MDA levels were lower in treatment groups than control group, but tissue GSH-Px, SOD, CAT and XO levels were higher (p<0.05 for MDA and p<0.001 for others). Samples in control group histopathologically showed morphologic abnormalities specific to ischemia reperfusion. It has been found that both preoperative and intraoperative diosmin treatment decreases cellular damage and protects cells from toxic effects in liver IRI. As a conclusion, diosmin may be used as a protective agent against IRI in elective and emergent liver surgical operations.