Heparin protects against skin flap necrosis: relationship to neutrophil recruitment and anti-coagulant activity

Törkvist, Leif; Löfberg, Robert; Raud, J.; Thorlacius, Henrik

doi:10.1007/s00011-003-1218-0

Cited by 12 publications

(6 citation statements)

References 15 publications

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“…Nearly 75% (53 of 71) of studies evaluated results after 7 days of follow-up. Ten articles used 14 days of follow-up period, 30,32–40 whereas 4 articles used 10 days, 19,41–43 2 articles used 4 days 20,44 and each 1 article used 3, 45 5, 46 6, 47 and 8 48 days.…”

Section: Resultsmentioning

confidence: 99%

Standardization of the Rat Dorsal Random Pattern (McFarlane) Flap Model and Evaluation of the Pharmacological Agents Aiming to Salvage Partial Flap Necrosis

2021

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Introduction Partial flap necrosis is a common complication after surgery. McFarlane flap model has been used for assessment of various agents' effects on random flap survival. The aim of this study was to review the methodology of studies using this flap model and reveal the most successful agents. Materials and Methods PubMed, Scopus, and Web of Science databases were screened for words “McFarlane flap,” “flap survival,” and (“flap” and “rat”) by using time limits between 1965 and 2019. A total of 71 original articles were reviewed. Dimensions and base (cranial/caudal) of the flap, treatment protocol, follow-up period, and survival rates were extracted. Modified survival rates were calculated. Coefficients of variation of cranial/caudally based control group flaps and most commonly used flap models were calculated to assess interstudy variability. Results A total of 165 different treatment regimens were studied. One-hundred twelve regimens (67.9%) were found to increase flap survival. Most common flap dimensions were 9 cm × 3 cm, followed by 10 cm × 3 cm, 8 cm × 2 cm and 6 cm × 2 cm. Studies using caudally based flaps showed less interstudy variability, but survival rates were similar. Pentoxifylline, sildenafil, chlorpromazine, phenoxybenzamine, and phentolamine were reported to be successful in multiple studies. Conclusions There are numerous agents found to be effective for treatment of partial flap necrosis, but further clinical research is needed. To overcome standardization problems, use of commonly used flap dimensions with a caudal base and interpretation of results after 7 days of follow-up seems appropriate.

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Section: Resultsmentioning

confidence: 99%

Standardization of the Rat Dorsal Random Pattern (McFarlane) Flap Model and Evaluation of the Pharmacological Agents Aiming to Salvage Partial Flap Necrosis

2021

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“…Heparin, for example, has been shown to reduce postoperative flap thrombosis 39 with anticoagulative, rather than anti-inflammatory, effects demonstrated to be the basis of improved flap outcomes. 40 Tissue plasminogen activator (TPA) has been demonstrated to have similar antithrombolytic benefits in flap patients, 41 capable of restoring capillary perfusion in muscle flaps after thrombogenic insult. 42 DCA has been reported to increase TPA and decrease plasminogen activator inhibitor-1 (PAI-1) expression under hypoxic conditions.…”

Section: Tyner Et Almentioning

confidence: 99%

Dichloroacetate Reduces Tissue Necrosis in a Rat Transverse Rectus Abdominis Musculocutaneous Flap Model

Tyner¹,

Tong²,

Donovan³

et al. 2006

Annals of Plastic Surgery

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“…Howeer, prolonged tissue ischemia in setting of trauma or prolonged procedures can lead to tissue necrosis and eventual demise of the skin flap [1,2]. Despite remarkable progress in plastic surgery over the previous two decades, partial flap necrosis has been reported in 7-20% of free flaps and 20-33% of pedicled flaps [3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Effect of Systemic Antioxidant Allopurinol Therapy on Skin Flap Survival.

Ardakani

Al‐Dam

Rashad

et al. 2017

Adv Plast Reconstr Surg

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Background: This study was undertaken to evaluate whether steady state concentrations of allopurinol can improve ischemia in canine skin flaps.Methods: Twenty dogs underwent one skin flap surgery with a 2-week interval. The first procedure was performed according to the standard protocols. The second phase was started by a 1-week pretreatment with allopurinol. Length of the necrotic zone was measured and recorded daily. At each phase, flaps were removed and sent for histopathological study after 1week observation.Results: Mean length of the necrotic zone in allopurinol treated skin flaps has been significantly less than normal flaps over all 7 days of observation (p-value<0.0001). Histopathology study showed less inflammation and more normal tissue structure in the allopurinol treated skin flaps. Conclusions:Findings obtained from our study demonstrate that systemic administration of allopurinol significantly improves skin flap survival and may have significant clinical implications.

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Heparin protects against skin flap necrosis: relationship to neutrophil recruitment and anti-coagulant activity

Abstract: In conclusion, we demonstrate that protective effect of clinically relevant doses of heparin correlates with its ability to prolong clotting time and not to inhibition of neutrophil accumulation in the healing of skin flaps.

Cited by 12 publications

References 15 publications

Standardization of the Rat Dorsal Random Pattern (McFarlane) Flap Model and Evaluation of the Pharmacological Agents Aiming to Salvage Partial Flap Necrosis

Standardization of the Rat Dorsal Random Pattern (McFarlane) Flap Model and Evaluation of the Pharmacological Agents Aiming to Salvage Partial Flap Necrosis

Dichloroacetate Reduces Tissue Necrosis in a Rat Transverse Rectus Abdominis Musculocutaneous Flap Model

Effect of Systemic Antioxidant Allopurinol Therapy on Skin Flap Survival.

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