Piroglu, Isilay; Tulgar, Serkan; Thomas, David Terence; Cakiroglu, Basri; Piroglu, Mustafa Devrim; Bozkurt, Yasin; Gergerli, Ruken; Ates, Nagihan Gozde

Background: Mechanical bowel preparation before colorectal surgery is commonly performed, but its benefits are controversial. The aim of this study was to compare the effects of mechanical bowel preparation on healing of colonic anastomosis and tissue strength. Material/Methods: After institutional review board approval, 20 adult Wistar albino rats were randomly divided into 2 groups of 10 animals each. Mechanical bowel preparation including sodium phosphate was performed on the experimental group via a feeding tube, whereas no bowel preparation procedures were performed on the control group. Transverse colon resection and anastomosis were performed on all rats under general anaesthesia. On postoperative day 5, re-laparotomy was performed and the anastomotic areas were resected. Animals were killed, after which bursting pressure and tissue hydroxyproline concentrations were measured, histopathological examination was performed, and we evaluated and compared the results. Results: There were no differences between control and experimental groups in bursting pressure, tissue hydroxyproline concentrations, or histopathological examination results (P>0.05). Conclusions: Our study demonstrated no significant difference between bursting pressures, tissue hydroxyproline levels, or modified wound healing score at postoperative day 5 between rats undergoing and not undergoing mechanical bowel preparation. Mechanical bowel preparation is not essential for healing or strength of colonic anastomosis in rats.

Piroglu, Isilay Demir; Tulgar, Serkan; Piroglu, Mustafa Devrim; Thomas, David Terence; Karakilic, Evvah; Gergerli, Ruken; Ates, Nagihan Gozde; Demir, Ahmet

Aim: Burn patients in intensive care units (ICU) are at high risk of mortality. Our aim in this stuy is to evaluate the use of first 48 hour procalcitonin level (PCT), C-reactive protein (CRP) and APACHE II score for the prediction of mortality in burn patients admitted to ICU. Material and method: Files of patients with burns admitted to a tertiary centre's burn unit were retrospectively analysed and those with procalcitonin and C-reactive protein level measurements and APACHE II scores within first 48 hours of admittance were included in this study. Patients with comorbidities that would effect PCT and CRP levels such as chronic renal or liver failure were excluded from the study. Patients PCT, CRP and APACHE II scores were compared with the outcome of patients. Results: Seventy patients were included in this study. While CRP levels were lower in patients that were deceased, PCT levels were significantly higher in these patients. In patients with APACHE II score > 20 and PCT > 2 ng/ml, mortality was statistically very significantly higher compared with other patients. Logistical regression analysis showed that high PCT levels and APACHE II scores were important at predicting mortality in these patients. Conclusion: High PCT levels within 48 hours of burns is a predictor of mortality in these patients. Additional studies are required to correctly determine the cut-off value. A modified scoring system including APACHE II and PCT may be useful for better predicting mortality, although larger multi-centered studies are required.