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BSP-3
(P)
INVESTIGATION OF THE EFFECT OF PENILE TOURNIQUET APPLICATION TO
BACTERIAL ADHESION
Ozlem BOYBEYI
1
, Birgul KACMAZ
2
, Esra ARAT
3
, Pinar ATASOY
4
, Ucler KISA
5
, Yasemin DERE GUNAL
6
, Mustafa Kemal
ASLAN
6
and Tutku SOYER
7
1) HACETTEPE UNIVERSITY MEDICAL FACULTY, DEPARTMENT OF PEDIATRIC SURGERY, Ankara, TURKEY - 2) KIRIKKALE
UNIVERSITY, MEDICAL FACULTY, DEPARTMENT OF CLINICAL MICROBIOLOGY AND INFECTIOUS DISEASES, Kirikkale,
TURKEY - 3) KIRIKKALE UNIVERSITY, SCIENCE FACULTY, DEPARTMENT OF BIOLOGY, Kirikkale, TURKEY - 4) KIRIKKALE
UNIVERSITY, MEDICAL FACULTY, DEPARTMENT OF PATHOLOGY, Kirikkale, TURKEY - 5) KIRIKKALE UNIVERSITY,
MEDICAL FACULTY, DEPARTMENT OF BIOCHEMISTRY, Kirikkale, TURKEY - 6) KIRIKKALE UNIVERSITY, MEDICAL
FACULTY, DEPARTMENT OF PEDIATRIC SURGERY, Kirikkale, TURKEY - 7) HACETTEPE UNIVERSITY, MEDICAL FACULTY,
DEPARTMENT OF PEDIATRIC SURGERY, Ankara, TURKEY
PURPOSE
Penile tourniquet (PT) application might decrease local tissue perfusion and alter cell integrity causing increased
bacterial adhesion. Experimental study was conducted to evaluate the effect of PT to bacterial adhesion.
MATERIAL AND METHODS
Fifty-six rats were allocated into control group (CG, n=7), sham group (SG, n=21), PT group (PTG, n=21). No
intervention was done in CG. A 5 mm-length urethral repair was performed in SG and PTG. In PTG, 10min-duration PT
was applied during procedure and tissue oxygenation monitor (MoorVMS-OXY) was used to achieve same degree of
ischemia in all subjects. SG and PTG were allocated into 3 subgroups according to time of tissue harvesting; 1 hour (SG-
1, PTG-1), 24 hour (SG-2, PTG-2), and 72 hour (SG-3, PTG-3). Samples were examined biochemically (nitric-oxide-NO,
malondialdehyde-MDA, myeloperoxidase-MPO, TNF-α, IL-1β), histopathologically (wound healing scores) and electron
microscopically (bacterial adhesion screening).
RESULTS
MDA, MPO, TNF-α, IL-1β levels were significantly decreased in SG and PTG compared to CG (p<0.05). However, there
was no difference between SG and PTG (p>0.05). The mean values of biochemical markers did not show significant
difference in early and late harvested samples (p>0.05). Wound healing scores were higher in SG than CG and in PTG
than CG and SG (p<0.05). The scores were significantly altered in samples with late harvesting time (p<0.05). Electron
microscopic examination showed higher bacterial adhesion in PTG than CG and SG.
CONCLUSIONS
PT did not cause inflammatory marker exhaustion and oxidative injury after urethral repair. However, tourniquet
application alters histopathological findings of wound healing and causes increased bacterial adhesion. Since these
adverse findings became prominent at 72 hour after application, we can suggest that PT may cause postoperative
complications such as wound dehiscence and infection.