Pengaruh Pemberian Fenitoin Oral dan Vitamin C Oral terhadap Jumlah Kolagen dan Diameter pada Fistula Enterokutan Tikus Wistar
Effect Phenytoin and Vitamin C Therapy to Collagen Deposition and Diameter of Enterocutaneous Fistula in Wistar Rat
DOI:
https://doi.org/10.36408/mhjcm.v9i3.766Keywords:
Enterocutaneous fistula, Fenitoin, Vitamin C, kolagen, Diameter fistulaAbstract
Latar Belakang : Enterocutaneous fistula (ECF) adalah salah satu tantangan bagi banyak ahli bedah di dunia. Meskipun terdapat perkembangan dalam perawatan medis dan tekhnik operasi, namun morbiditas dan mortalitas terkait ECF masih tinggi. Keberhasilan dalam tatalaksana ECF memerlukan perawatan yang komprehensif dan sumber daya yang mahal, dimana tidak terjangkau oleh sebagian masyarakat Indonesia. Fenitoin dan Vitamin C adalah obat yang murah dan telah menunjukan manfaat baik dalam penyembuhan luka.
Tujuan : Penelitian ini bertujuan untuk mengetahui apakah pemberian fenitoin dan vitamin C akan meningkatkan kolagenisasi dan menurunkan diameter ECF pada tikus wistar. Kemudian untuk mengevaluasi apakah pemberian kombinasi fenitoin dan vitamin C memberikan hasil yang lebih baik dibandingkan pemberian tunggal fenitoin atau fitamin C
Metode : Peneliti membuat caecostoma sebagai model ECF pada 24 ekor tikus. Tikus kemudian dibagi menjadi empat kelompok perlakuan dengan : perawatan NaCl, Kombinasi fenitoin-vitamin C, Fenitoin saja dan Vitamin C saja. Pengamatan hasil dilakukan pada hari ke-7 dengan mengamati deposisi kolagen dan mengukur diameter ECF.
Hasil : Penelitian ini menunjukan perbedaan kolagenisasi dan penurunan diameter ECF bermakna secara statistik (p<0.05) pada tiap kelompok perlakuan jika dibandingkan kelompok kontrol (5,521 + 2,552 %; 9,395 ± 0,582 mm). Penelitian ini juga mengungkapkan bahwa pemberian kombinasi fenitoin dengan vitamin C (28,110 ± 6,535 %; 5,742 ± 0,394 mm) memberikan hasil yang lebih baik (p<0.05) dibanding pemberian tunggal fenitoin (15,448 ± 5,184 %; 8,101 ± 0,822 mm) atau vitamin C (19,118 ± 4,190 %; 6,883 ± 0,744 mm).
Kesimpulan : Kami menyimpulkan baik fenitoin maupun vitamin C memiliki efek baik dalam penyembuhan ECF. Pemberian kombinasi Fenitoin dan vitamin C terbukti lebih bermanfaat dibandingkan pemberian tunggal.
Kata Kunci : Enterocutaneous fistula, Fenitoin, Vitamin C, kolagen, Diameter fistula
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References
Dodiyi-Manuel A, Wichendu PN. Current concepts in the management of enterocutaneous fistula. International Surgery Journal. 2018;5(6):f81-5.
Dumas R, Moore S, Sims C. Enterocutaneous Fistula: Evidence-based Management. Clin Surg 2017; 2. 2017;1435.
Gribovskaja-Rupp I, Melton GB. Enterocutaneous fistula: proven strategies and updates. Clinics in colon and rectal surgery. 2016;29(02):130-7.
Okoli C, Oparocha D, Onyemkpa J. Enterocutaneous Fistula: Aetiology and management outcome in a tertiary center in Nigeria. Afrimedic Journal. 2013;4(1):17-21.
Haack CI, Galloway JR, Srinivasan J. Enterocutaneous fistulas: a look at causes and management. Current surgery reports. 2014;2(10):71.
Weledji E. Perspectives on enterocutaneous fistula: A review article. Med Clin Rev. 2017;3:5.
Wercka J, Cagol PP, Melo ALP, Locks GdF, Franzon O, Kruel NF. Epidemiology and outcome of patients with postoperative abdominal fistula. Revista do Colégio Brasileiro de Cirurgiões. 2016;43(2):117-23.
Heimroth J, Chen E, Sutton E. Management Approaches for Enterocutaneous Fistulas. The American Surgeon. 2018;84(3):326-33.
Wainstein DE, Fernandez E, Gonzalez D, Chara O, Berkowski D. Treatment of high-output enterocutaneous fistulas with a vacuum-compaction device. A ten-year experience. World journal of surgery. 2008;32(3):430-5.
Lambert K, Hayes P, McCarthy M. Vacuum assisted closure: a review of development and current applications. European journal of vascular and endovascular surgery. 2005;29(3):219-26.
Limengka Y, Jeo WS. Spontaneous closure of multiple enterocutaneous fistula due to abdominal tuberculosis using negative pressure wound therapy: a case report. Journal of Surgical Case Reports. 2018;2018(1):rjy001.
Wang W, Pan Z, Hu X, Li Z, Zhao Y, Yu A. Vacuum‑assisted closure increases ICAM‑1, MIF, VEGF and collagen I expression in wound therapy. Experimental and therapeutic medicine. 2014;7(5):1221-6.
Sengupta M, Banerjee P, Paul S, Sengupta J, Ghosh M. Healing effect of phenytoin on excisional wound in experimental albino rats. Muller J Med Sci Res. 2015;6:27-30.
Hajong R, Naku N, Hajong D, Anand M, Lenish K, Singh NM. Effect of topical phenytoin on wound healing. Group. 2016;1(50):17.36.
Hagh LG, Karimi B, Moghimipour E, Abdi Z, Abdolalian F, Rohani A. Histological Evaluation of Wound Healing Effect of Topical Phenytoin on Rat Hard Palate Mucosa. Journal of Research in Medical and Dental Science. 2018;6(2):466-72.
Jaber SA, Fallatah BM, Tayara B, Yami H, Abdelmoeti M. Intravenous phenytoin: potential new therapy for gastrointestinal fistulae. J Surg. 2013;1(3):11-4.
Shakeri F, Tebyanian H, Karami A, Babavalian H, Tahmasbi MH. Effect of topical phenytoin on wound healing. Trauma Monthly. 2017;22(5).
Jaber S, Rihy Z, Joseph R, Al-Khayat M. Does phenytoin improve the healing of gastrointestinal fistulas? Case reports in gastroenterology. 2011;5(1):52-5.
Firmino F, Almeida AMPd, Alves GdS, Grandeiro DdS, Penna LHG. Scientific production on the applicability of phenytoin in wound healing. Revista da Escola de Enfermagem da USP. 2014;48(1):162-9.
Turan M, Saraydin SU, Canbay E, Karadayi K, Bulut E, Cetinkaya Ö, et al. Positive effects of phenytoin on experimental colonic anastomoses. International journal of colorectal disease. 2004;19(3):250-7.
Mohammed BM, Fisher BJ, Kraskauskas D, Ward S, Wayne JS, Brophy DF, et al. Vitamin C promotes wound healing through novel pleiotropic mechanisms. International wound journal. 2016;13(4):572-84.
Dudrick SJ, Maharaj AR, McKelvey AA. Artificial nutritional support in patients with gastrointestinal fistulas. World journal of surgery. 1999;23(6):570-6.
Valsangkar N, Schmidt H, Nancy Strange R, Wooden W, Ceppa EP. Is scurvy a 21st century diagnosis? Implications on surgical patients. 2019.
Bültmann O, Philipp C, Ladeburg M, Berlien H-P. Creation of a caecostoma in mice as a model of an enterocutaneous fistula. Research in experimental medicine. 1998;198(4):215-28.
McPherson JM, Piez KA. Collagen in dermal wound repair. The molecular and cellular biology of wound repair: Springer; 1988. p. 471-96.
Li J, Chen J, Kirsner R. Pathophysiology of acute wound healing. Clinics in dermatology. 2007;25(1):9-18.
Schultz GS, Chin GA, Moldawer L, Diegelmann RF. Principles of Wound Healing. Mechanisms of Vascular Disease: A Reference Book for Vascular Specialists [Internet]: University of Adelaide Press; 2011.
Meena K, Mohan A, Sharath B, Somayaji S, Bairy K. Effect of topical phenytoin on burn wound healing in rats. 2011.
Kato T, Okahashi N, Ohno T, Inaba H, Kawai S, Amano A. Effect of phenytoin on collagen accumulation by human gingival fibroblasts exposed to TNF‐αin vitro. Oral diseases. 2006;12(2):156-62.
Ronchetti IP, Quaglino D, Bergamini G. Ascorbic acid and connective tissue. Subcellular biochemistry: Springer; 1996. p. 249-64.
Sharma S, Poddar R, Sen P, Andrews J. Effect of vitamin C on collagen biosynthesis and degree of birefringence in polarization sensitive optical coherence tomography (PS-OCT). African Journal of Biotechnology. 2008;7(12).
Corrêa JD, Queiroz-Junior CM, Costa JE, Teixeira AL, Silva TA. Phenytoin-induced gingival overgrowth: a review of the molecular, immune, and inflammatory features. ISRN dentistry. 2011;2011.
Jagetia G, Rajanikant G, Baliga M, Rao K, Kumar P. Augmentation of wound healing by ascorbic acid treatment in mice exposed to γ‐radiation. International journal of radiation biology. 2004;80(5):347-54.
Theoret C. Physiology of wound healing. Equine wound management. 2016:1-13.
Teller P, White TK. The physiology of wound healing: injury through maturation. Perioperative Nursing Clinics. 2011;6(2):159-70.
Usha N, Sirisha G. IJBCP International Journal of Basic and Clinical Pharmacology. International Journal of Basic and Clinical Pharmacology. 2016;5(6):2684.
Bikker A, Wielders J, Van Loo R, Loubert M. Ascorbic acid deficiency impairs wound healing in surgical patients: Four case reports. International Journal of Surgery Open. 2016;2:15-8.
Dill RE, Iacopino AM. Myofibroblasts in phenytoin‐induced hyperplastic connective tissue in the rat and in human gingival overgrowth. Journal of periodontology. 1997;68(4):375-80.
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