Is It Possible To Increase Flap Viability by Hydrostatic Dilation? An Experimental Study in the Rat Abdominal Fasciocutaneous Flap Model

Şahi̇n, Ci̇han; Aysal, Bilge Kagan; Ergün, Özge

doi:10.1097/01.prs.0000455541.84409.71

Cited by 3 publications

(3 citation statements)

References 2 publications

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“…The time interval between the initial impact and the flap surgery also depends on whether the preconditioning is planned as a surgical or non‐surgical procedure. In respect to the recent experimental studies using non‐surgical strategies on rat model targeting flap vascularization, 7 days of interval for flap preconditioning was planned .…”

Section: Discussionmentioning

confidence: 99%

Photobiomodulation with polychromatic light increases zone 4 survival of transverse rectus abdominis musculocutaneous flap

Çalış¹,

Demirtas

Sert³

et al. 2019

Lasers Surg Med

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Objective The aim of this study was to evaluate the effect of relatively novel approach of application of polychromatic light waves on flap survival of experimental musculocutaneous flap model and to investigate efficacy of this modality as a delay procedure to increase vascularization of zone 4 of transverse rectus abdominis musculocutaneous (TRAM) flap. Methods Twenty‐one Wistar rats were randomized and divided into 3 experimental groups (n = 7 each). In group 1 (control group), after being raised, the TRAM flap was sutured back to its bed without any further intervention. In group 2 (delay group), photobiomodulation (PBM) was applied for 7 days as a delay procedure, before elevation of the flap. In group 3 (PBM group), the TRAM flap was elevated, and PBM was administered immediately after the flap was sutured back to its bed for therapeutic purpose. PBM was applied in 48 hours interval from 10 cm. distance to the whole abdominal wall both in groups 2 and 3 for one week. After 7 days of postoperative follow‐up, as the demarcation of necrosis of the skin paddle was obvious, skin flap survival was further evaluated by macroscopic, histological and microangiographic analysis. Results The mean percentage of skin flap necrosis was 56.17 ± 23.68 for group 1, 30.92 ± 17.46 for group 2 and 22.73 ± 12.98 for group 3 PBM receiving groups 2 and 3 revealed less necrosis when compared to control group and this difference was statistically significant. Vascularization in zone 4 of PBM applied groups 2 and 3 was higher compared to group 1 (P = 0.001). Acute inflammation in zone 4 of group 1 was significantly higher compared to groups 2 and 3 (P = 0.025). Similarly, evaluation of zone 1 of the flaps reveled more inflammation and less vascularization among the samples of the control group (P = 0.006 and P = 0.007, respectively). Comparison of PBM receiving two groups did not demonstrate further difference in means of vascularization and inflammation density (P = 0.259). Conclusion Application of PBM in polychromatic fashion enhances skin flap survival in experimental TRAM flap model both on preoperative basis as a delay procedure or as a therapeutic approach. Lasers Surg. 51:538–549, 2019. © 2019 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Photobiomodulation with polychromatic light increases zone 4 survival of transverse rectus abdominis musculocutaneous flap

Çalış¹,

Demirtas

Sert³

et al. 2019

Lasers Surg Med

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“…Hydrodissection 22 , tens application 23 , microneedling with dermaroller 24 have shown to increase flap perfusion experimentally and they also need no systemic drug use.…”

Section: Discussionmentioning

confidence: 99%

Topikal Atorvastatinin Random Paternli Cilt Fleplerinin Yaşayabilirliğine Etkisi ,Deneysel Çalışma

Can¹,

Özturan²,

Oral³

et al. 2021

Osmangazi̇ Journal of Medicine

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Augmentation of viability of random pattern flaps has long been an issue in plastic surgery. Up to date no agents were clinically introduced. Atorvastatins are used clinically for lipid lowering. They are also effective on flap survival with their angiogenic, antiinflammatory, antioxidant effects with systeic administration. In this study, Atorvastatin is used topically for flap survival alleviation in Mc Farlane flap in rats. Wibstar albino type 20 male rats weighing about 180-230 grams were classified as experiment and control group. Results were evaluated by flap necrosis ratios, lymphocyte cells, neutrophile cells, capillary and granulation tissue density on the 7th postoperative day.. Flap necrosis areas were evaluated with Sasaki's paratemplate method. Tissue biopsies of 1x1 cm at the transition zone between necrotic and healthy tissue, were embedded in parafin blocks after fixation in 10% formalin. Biopsies were sliced by 4 micrometer thickness with a microtome. Cross sections were painted with hematoxylene eosin and evaluated with a light microscope. Whitneyy U test was performed for clinical and histopathological evaluation of groups (p<0,05). Flap viability was alleviated. Average necrosis ratios on flaps were 32.1% in the control group and 14.17% in experimental group. Capillary tissue and neutrophile cell density were found to be higher in atorvastatin group. . Granulation tissue and lymphocyte cell density were not found significantly higher.. Atorvastatins, when applied topically, are effective on flap survival. Further studies should be carried out for human clinical use.

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“…[1][2][3][4][5] Flap vascular anatomy is usually studied by microangiography, which has been proven a reliable technique. 1,[5][6][7][8] However it is invasive and only provides information on the vascularity of the flap and cannot be used to assess and quantify inflammation, necrosis, and flap measurements. Also, it is a less suitable study when analyzing flap physiology.…”

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confidence: 99%

Role of Ultrahigh Frequency Ultrasound in Evaluating Experimental Flaps

Morărașu

Gheţu

Coman

et al. 2020

J Reconstr Microsurg

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Background Experimental flap follow-up needs faster, safer, and less invasive techniques that can be easily correlated to clinical procedures. For this reason, we aimed to test the role of ultrahigh frequency ultrasound in follow-up of flap viability. Further on, we aimed to analyze if the chimeric groin flap can be mobilized in a sandwiched position without affecting its vascular supply by twisting its pedicle. Methods A total of 12 male Wistar rats, split into three groups, were used. Group A (n = 4) had the chimeric groin flap repositioned in a sandwich position on the anterior abdominal wall and underwent ultrahigh frequency ultrasound follow-up at days 10 and 14. Group B (n = 4) also had the flaps sandwiched, however, at day 14 the vascularity of flaps was proven by infusion of nontargeted ultrasound contrast agents, after which flaps were sent for histological analysis. Group C (C1 n = 2, C2 n = 2) was the control group. In C1 the chimeric groin flap was harvested and sent for histology on day 0, acting as a histological benchmark of flap viability, and in C2 the chimeric groin flap was re-sutured in its anatomical position and after 14 days, flaps were harvested and sent for histological analysis, acting as a direct control for Group B. Results Ultrasound showed constant vascular flow in both adipose and skin flaps in the sandwiched position. Microbubble study showed diffuse perfusion within flaps. Ultrasound measurements of flow velocity, flap volume, and percentage of vascularity showed a decrease in flap volume and increase in vascularity over 14 days. Histology showed similar viability in both groups. Conclusion Ultrahigh frequency ultrasound may be a valuable tool for postoperative flap assessment, while the chimeric flap can be moved freely in a sandwich position making it suitable for adding tissue substitutes within its components.

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Is It Possible To Increase Flap Viability by Hydrostatic Dilation? An Experimental Study in the Rat Abdominal Fasciocutaneous Flap Model

Cited by 3 publications

References 2 publications

Photobiomodulation with polychromatic light increases zone 4 survival of transverse rectus abdominis musculocutaneous flap

Photobiomodulation with polychromatic light increases zone 4 survival of transverse rectus abdominis musculocutaneous flap

Topikal Atorvastatinin Random Paternli Cilt Fleplerinin Yaşayabilirliğine Etkisi ,Deneysel Çalışma

Role of Ultrahigh Frequency Ultrasound in Evaluating Experimental Flaps

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