Konsantre büyüme faktörünün random patern cilt flep yaşayabilirliği üzerine etkisi: deneysel çalışma

Abstract

Introduction: Random pattern skin flaps are used frequently for the reconstruction of random pattern skin defects from various causes in plastic and reconstructive surgery. Most frequent complication with these flaps is the necrosis of distal parts due to inadequate blood supply. Various types of techniques have been defined to avoid and reduce flap loss. The aim of this study is, for the first time, to evaluate the effect of concentrated growth factor (CGF), which is derived from whole blood and is rich in growth factors, on the survival of random pattern skin flaps. Material and Method: Fifty Sprague-Dawley rats were used for the study. Forty of them were used for the experiment group and ten for the preparation of CGF. Distal based 3x9 cm McFarlene flaps were elevated from the back of the rats and in CGF group (n:20), CGF matrix was placed before closure. No treatment was given to the control group (n:20). On postoperative day 7, the flaps were evaluated by photographic, scintigraphic, and histopathological methods. Results: The median rate of surviving flap areas in control group was 53% (47-58). In CGF group the median rate of flap viability was %58 (55-64). The higher flap viability rates obtained from CGF applied group was found to be statistically significantly higher from control group (p<0,001). For the scintigraphic perfusion area evaluations, the median rate of flap perfusion was 54% (51-60) for the control group and 61% (59-64) for the CGF group. The higher flap perfusion rates obtained from CGF applied group was found to be statistically significantly higher from control group (p=0,001). The median rate of vascularity scores in CGF treated group was 10,0 (8,25-11,75) and 7,5 (6,25-9,00) in control group. The difference was found to be statistically significantly higher in the study group (p=0,003). Inflammation scores were not found to be statistically significantly different (p=0,246). Conclusions: This study shows that locally applied CGF under skin flap increases flap viability which might be associated with the increase in angiogenesis. This study for the first time shows that in flap surgery, applying CGF which is rich in growth factors, might have favorable effects on the flaps that are prone to ischemia but further studies are needed.