Effect of Aspirin and Heparin on Random Skin Flap Survival in Rats

Abstract

It appears that high-dose aspirin increases survival of ischemic flap tissue irrespective of the presence of microvascular anastomosis and may be of clinical benefit in all flap surgery. The authors have indicated no significant interest with commercial supporters.

Effects of Clopidogrel and Low-Molecular-Weight Heparin on Viability of Random Skin Flaps in Rats

“…4,23 Two important mechanisms have been implicated in postsurgical damage: neutrophilic influx and vascular thrombosis. 10 Platelets are pivotal in vascular thrombosis, as is venous blood flow. Exposed subendothelial matrix and factors releasing prothrombin result in activation and adhesion of platelets at the onset of thrombus formation.…”

“…21 Low-dose enoxaparin also exerts anti-inflammatory effects in animal models and in humans, so its therapeutic effects may be attributable to a combination of anticoagulant and anti-inflammatory properties. 10 However, some researchers maintain that its anticoagulant activity is key, based on microcirculatory changes. 21 Aral et al compared various pharmacological compounds, thrombolytic, anticoagulant, and vasodilator agents in rats and found significant improvement in the necrotic area only with the use of LMWH.…”

“…7 However, a constant infusion of heparin failed to improve survival of random flaps in a pig model. 9 Other related studies include work by Shalom et al, 10 demonstrating no benefit from heparin in terms of flap survival, and a lack of prophylactic efficacy cited by Bielecki et al 11 On the other hand, use of subcutaneous LMWH reportedly enhanced flap survival in an animal model developed by Miyawaki et al, 6 and Törkvist et al 8 determined that heparin at clinical dosages markedly improved rat skin flap viability.…”

Effects of Traditional Chinese Medicine Shuxuetong Injection on Random Skin Flap Survival in Rats

“…Several pharmacological agents have been used in efforts to prevent or reverse skin flap ischemia. These include vascular endothelial growth factor (VEGF) [3], aspirin [4], and eutectic mixture of local anesthetics (EMLA; a mix of lidocaine and prilocaine) [5]. …”

Comparison of Bone Marrow-derived Mononuclear Cells vs. Mesenchymal Stem Cells in Protecting Random-pattern Skin Flap Survival in Rats

“…Two days before operation (day -2), cells were subcutaneously injected in 7 points on the dorsal skin evenly (cell numbers for transplantation are described below). On day 0, an 8-cm×2-cm random-pattern skin flap was raised and sutured back in situ using a 3-0 silk suture [12]. The survival area of the skin flaps was measured on day 7.…”