Amoksisilin ve Klindamisin Emdirilmiş İpek ve Vikril Sütür Malzemelerinin, Antibiyotik Salınımlarının İncelenmesi, İn Vitro Çalışma
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Oral cerrahi işlemlerden sonra gelişebilecek enfeksiyonu önlemek için yapılan uygulama, sistemik antibiyotik reçete etmektir. Sistemik kullanımlarda, plazmada etkili dozun devamı için tekrarlayan uygulamalara ihtiyaç duyulmaktadır. Kontrollü ilaç salınım sistemlerinde; ilacın, etkin dozda ve sürede, etki etmesi istenen bölgede salınımı sağlanmakta ve sürekli ilaç kullanılması gereksinimi ortadan kalkmaktadır. Bu çalışmada sütürlere emdirme yoluyla elde edilen antibiyotiklerin kontrollü salınım seviyeleri incelenmiş ve lokal antibiyotik etkinliğinden faydalanarak bu yöntemin klinik pratikte uygulanabilirliği değerlendirilmiştir. Yöntemler: Amoksisilin ve klindamisin grubu saf antibiyotikler, ipek ve vikril sütürlere emdirilmiştir. Sütürlerin antibiyotik emilimlerinin arttırılabilmesi amacıyla jet plazma sistemi ile argon gazı uygulanmıştır. Çalışmamızda farklı çapraz bağların etkinliklerini de incelemek üzere toplam 8 grupta deneyler 3 kez tekrarlanmıştır. Çapraz bağlayıcı ajanlar olarak kitosan ve glutaraldehit kullanılmıştır. Sütürler fosfat tamponlu salin içerisinde bekletilerek, 6, 12, 24 ve 36. saatlerde LC-MS/ MS cihazında kontrollü antibiyotik salınımları ölçülmüştür. Bulgular: İn-vitro koşullarda yapılan deneyler sonucunda; sütür, çapraz bağlayıcı ve antibiyotik etkileşimi, salınım değerleri üzerinde istatistiksel olarak anlamlı bulunmuştur (p<0,001). Antibiyotik salınımı en yüksek olarak; ipek, glutareldehit ve klindamisin grubunda (591,6 ng/ml), buna en yakın değer; ipek, kitosan ve klindamisin grubundadır (190,21 ng/ml). En düşük salınım ise ipek, glutaraldehit ve amoksisilin grubunda bulunmuştur (2,58 ng/ml). Sütürlerde ipek vikrile göre; çapraz bağlayıcılarda glutaraldehit kitosana göre ve antibiyotiklerde klindamisin amoksisiline göre salınım değerleri olarak anlamlı derecede yüksek bulunmuştur (p<0,001). Sonuçlar: Sütürler modifiye edilerek klinik pratikte uygulanabilirliği mümkün olan, kontrollü antibiyotik salınımı yapabilen malzemeler oluşturulmuştur. Çalışmanın sonuçları sistemik yan etkiyi minimuma indirecek şekilde antibiyotik emdirilmiş sütür malzemesi kullanımının klinik uygulamada yaygınlaşması için umut vadetmektedir.
The procedure to prevent infection that may develop after oral surgical procedures is to prescribe systemic antibiotics. In systemic uses, recurrent applications are needed for the continuation of the effective dose in plasma. With controlled drug release systems, release of the drug in the region which it's desired to act in an effective dose and time is ensured and the need of continuous use is eliminated. In this study, the controlled release levels of the antibiotics obtained by absorption to sutures were examined and the application of this method in clinical practice was evaluated by using local antibiotic activity. Amoxicillin and clindamycin group pure antibiotics are absorbed in silk and vicryl sizes. Argon gas was applied with jet plasma system to increase the antibiotic absorption of the sutures. In our study, the experiments were repeated 3 times in 8 groups to examine the activities of different cross-bonds. Chitosan and glutaraldehyde were used as cross-binding agents. The sutures were kept in a phosphate buffered saline and controlled antibiotic emissions were measured on LC-MS/ MS at 6, 12, 24 and 36 hours. As a result of experiments under in-vitro conditions; suture, cross-binder and antibiotic interaction was found to be statistically significant on the release values (p <0.001). Antibiotic release is the highest in silk with glutareldehyde and clindamycin group (591.6 ng/ml), the closest value to this is in the group of silk with chitosan and clindamycin (190,21 ng/ml). The lowest release was found in the group of silk with glutaraldehyde and amoxicillin (2.58 ng/ml). When compared, release values of silk sutures were found to be significantly higher than vicryl sutures, as for cross-binding agents glutareldehyde was found to be significantly higher than chitosan, and finally for antibiotics clindamycin was found to be significantly higher than amoxicillin(p <0.001). The sutures were modified and materials that can be applied in clinical practice, which can release controlled antibiotics were created. The results of the study is hopeful for the widespread use of antibiotic absorbed suture material to minimize systemic side effects.
The procedure to prevent infection that may develop after oral surgical procedures is to prescribe systemic antibiotics. In systemic uses, recurrent applications are needed for the continuation of the effective dose in plasma. With controlled drug release systems, release of the drug in the region which it's desired to act in an effective dose and time is ensured and the need of continuous use is eliminated. In this study, the controlled release levels of the antibiotics obtained by absorption to sutures were examined and the application of this method in clinical practice was evaluated by using local antibiotic activity. Amoxicillin and clindamycin group pure antibiotics are absorbed in silk and vicryl sizes. Argon gas was applied with jet plasma system to increase the antibiotic absorption of the sutures. In our study, the experiments were repeated 3 times in 8 groups to examine the activities of different cross-bonds. Chitosan and glutaraldehyde were used as cross-binding agents. The sutures were kept in a phosphate buffered saline and controlled antibiotic emissions were measured on LC-MS/ MS at 6, 12, 24 and 36 hours. As a result of experiments under in-vitro conditions; suture, cross-binder and antibiotic interaction was found to be statistically significant on the release values (p <0.001). Antibiotic release is the highest in silk with glutareldehyde and clindamycin group (591.6 ng/ml), the closest value to this is in the group of silk with chitosan and clindamycin (190,21 ng/ml). The lowest release was found in the group of silk with glutaraldehyde and amoxicillin (2.58 ng/ml). When compared, release values of silk sutures were found to be significantly higher than vicryl sutures, as for cross-binding agents glutareldehyde was found to be significantly higher than chitosan, and finally for antibiotics clindamycin was found to be significantly higher than amoxicillin(p <0.001). The sutures were modified and materials that can be applied in clinical practice, which can release controlled antibiotics were created. The results of the study is hopeful for the widespread use of antibiotic absorbed suture material to minimize systemic side effects.
Açıklama
Diş Hekimliği Uzmanlık
Anahtar Kelimeler
Diş Hekimliği, Dentistry
