Dolen, Utku Can
(Department of Plastic Surgery, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital)
,
Sungur, Nezih
(Plastic Surgery Clinic, Ankara Training and Research Hospital)
,
Koca, Gokhan
(Department of Nuclear Medicine, Ankara Training and Research Hospital)
,
Ertunc, Onur
(Department of Pathology, Medical School of Gazi University)
,
Bosi, Ayse Tulay Bagci
(Department of Public Health, Medical School of Hacettepe University)
,
Kocer, Ugur
(Plastic Surgery Clinic, Ankara Training and Research Hospital)
,
Korkmaz, Meliha
(Department of Nuclear Medicine, Ankara Training and Research Hospital)
Background It is still difficult to prevent partial or full-thickness flap necrosis. In this study, the effects of a cream containing menthol and methyl salicylate on the viability of random-pattern skin flaps were studied. Methods Forty female Sprague-Dawley rats were divided into two equal groups....
Background It is still difficult to prevent partial or full-thickness flap necrosis. In this study, the effects of a cream containing menthol and methyl salicylate on the viability of random-pattern skin flaps were studied. Methods Forty female Sprague-Dawley rats were divided into two equal groups. Caudally based dorsal random-pattern skin flaps were elevated, including the panniculus carnosus. In the study group, 1.5 mL of a cream containing menthol and methyl salicylate was applied to the skin of the flap, and saline solution (0.9%) was used in the control group. Upon completion of the experiment, flap necrosis was analyzed with imaging software and radionuclide scintigraphy. Histopathological measurements were made of the percentage of viable flaps, the number of vessels, and the width of the panniculus carnosus muscle. Results According to the photographic analysis, the mean viable flap surface area in the study group was larger than that in the control group (P=0.004). According to the scintigrams, no change in radioactivity uptake was seen in the study group (P>0.05). However, a significant decrease was observed in the control group (P=0.006). No statistically significant differences were observed between the groups in terms of the percentage of viable flaps, the number of vessels, or the width of the panniculus carnosus muscle (P>0.05). Conclusions Based on these results, it is certain that the cream did not reduce the viability of the flaps. Due to its vasodilatory effect, it can be used as a component of the dressing in reconstructive operations where skin perfusion is compromised.
Background It is still difficult to prevent partial or full-thickness flap necrosis. In this study, the effects of a cream containing menthol and methyl salicylate on the viability of random-pattern skin flaps were studied. Methods Forty female Sprague-Dawley rats were divided into two equal groups. Caudally based dorsal random-pattern skin flaps were elevated, including the panniculus carnosus. In the study group, 1.5 mL of a cream containing menthol and methyl salicylate was applied to the skin of the flap, and saline solution (0.9%) was used in the control group. Upon completion of the experiment, flap necrosis was analyzed with imaging software and radionuclide scintigraphy. Histopathological measurements were made of the percentage of viable flaps, the number of vessels, and the width of the panniculus carnosus muscle. Results According to the photographic analysis, the mean viable flap surface area in the study group was larger than that in the control group (P=0.004). According to the scintigrams, no change in radioactivity uptake was seen in the study group (P>0.05). However, a significant decrease was observed in the control group (P=0.006). No statistically significant differences were observed between the groups in terms of the percentage of viable flaps, the number of vessels, or the width of the panniculus carnosus muscle (P>0.05). Conclusions Based on these results, it is certain that the cream did not reduce the viability of the flaps. Due to its vasodilatory effect, it can be used as a component of the dressing in reconstructive operations where skin perfusion is compromised.
* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.
가설 설정
We hypothesized that a combination of menthol and MeSa could affect the viability of skin flaps due to the anti-inflammatory properties of these compounds and their effects on blood vessels. No similar previous studies were found in a thorough review of the English-language, French-language, and Turkish-language literature.
제안 방법
All surgical procedures and imaging studies were performed under general anesthesia, which was carried out with an intraperitoneal injection of 75−100 mg/kg of ketamine hydro-chloride (Ketalar, Eczacıbaşı, Istanbul, Turkey) and 10 mg/kg of 2% xylazine (Rompun, Bayer, Leverkusen, Germany).
All the rats were weighed before and after the experimental protocol with a digital scale in order to evaluate their physiological response to the surgery and to the cream.
All flaps were evaluated daily. On the seventh postoperative day, the rats were anesthetized and standardized photographs of the flaps were taken with a high-resolution digital camera (Fujifilm FinePix F80EXR, Fujifilm Holdings Corp., Beijing, China) be-fore suture removal. These images were then uploaded to a computer, and the surface areas of the entire flap and the ne-crotic part of the flap were calculated in mm2 using Adobe Photoshop CS5 software (Adobe Systems Inc.
The Mann-Whitney U test was used to compare the necrotic, viable, and total surface areas of the flaps, as calculated by photographic analysis. The ROIs and the MCFA were measured using radionuclide scintigraphy, and the percentage of necrotic areas, capillary vessel density, and the thickness of the PCM were analyzed by histopathology and compared between the study group and the control group. The Wilcoxon signed-rank test was used to compare the weight of the rats, the ROIs, and the MCFA with-in the same group.
3). The borders of the hyperemic parts of the flap were drawn manually, using the free hand method, and the flap area was calculated (Fig. 4). Those values were referred to as the manually marked count of the viable flap area (MCFA).
Microscopic images (40×) of the flaps were photographed. The thickness of PCM muscle was measured at the pedicle region, the necrotic region, and at the transition zone between these regions with the help of Adobe Photoshop CS5. Muscle thickness was measured in three different places in each region, and the arithmetic average of these measurements was used as the muscle thickness value for each region (Fig.
대상 데이터
Forty adult (three months old) female Sprague-Dawley rats weighing 179–267 g were divided into two groups of 20 each.
데이터처리
The Mann-Whitney U test was used to compare the necrotic, viable, and total surface areas of the flaps, as calculated by photographic analysis. The ROIs and the MCFA were measured using radionuclide scintigraphy, and the percentage of necrotic areas, capillary vessel density, and the thickness of the PCM were analyzed by histopathology and compared between the study group and the control group.
The ROIs and the MCFA were measured using radionuclide scintigraphy, and the percentage of necrotic areas, capillary vessel density, and the thickness of the PCM were analyzed by histopathology and compared between the study group and the control group. The Wilcoxon signed-rank test was used to compare the weight of the rats, the ROIs, and the MCFA with-in the same group. The Kruskal-Wallis test was used to compare the thickness of the PCM in different regions of the same flap.
Since the scintigraphy results were not normally distributed, a base-10 logarithmic transformation was applied. The trans-formed values were used for statistical analysis.
이론/모형
The Wilcoxon signed-rank test was used to compare the weight of the rats, the ROIs, and the MCFA with-in the same group. The Kruskal-Wallis test was used to compare the thickness of the PCM in different regions of the same flap.
성능/효과
09). A statistically significant decrease was observed in the values of ROI B and ROI C, both in the study group (P=0.04 and P=0.01, respectively) and in the control group (P=0.01 and P=0.00, respec-tively).
In this experimental study, the effects of a topical cream containing 10% menthol and 15% MeSa (Kamfo-lin, Münir Şahin, Istanbul, Turkey) on the viability of dorsal ran-dom-pattern skin flaps in rats were investigated.
Photographic analysis showed that the cream increased flap viability, although the number of the vessels did not change after the experiment. The finding that the total ROI and MCFA of the study group did not change, while the total ROI of the control group decreased after the experiment, may be attributed to the vasodilatory effect of the cream. This effect could possibly be used in flap surgeries or replantations in order to increase the perfusion of the flap.
후속연구
Its vasodilatory effect means that it can be incorporated as part of the dressing in reconstructive operations where skin perfusion is compromised. Nevertheless, further experiments are necessary to determine the optimal concentrations of menthol and MeSa (alone or in combination) for improving flap viability.
참고문헌 (25)
1 Rinker B Fink BF Barry NG The effect of calcium channel blockers on smoking-induced skin flap necrosis Plast Reconstr Surg 2010 125 866 871 20195113
2 Chen W Yang D Wang P Microencapsulated myoblasts transduced by the vascular endothelial growth factor (VEGF) gene for the ischemic skin flap Aesthetic Plast Surg 2011 35 326 332 20976598
3 Miyawaki T Jackson IT Bier UC The effect of capsaicin ointment on skin for the survival of a cutaneous flap Eur J Plast Surg 2001 24 28 30
4 Pal S Khazanchi RK Moudgil K An experimental study on the effect of nifedipine on ischaemic skin flap survival in rats Br J Plast Surg 1991 44 299 301 2059788
5 Stadelmann WK Hess DB Robson MC Aprotinin in ischemia-reperfusion injury: flap survival and neutrophil response in a rat skin flap model Microsurgery 1998 18 354 361 9846997
8 Johnson CD Melanaphy D Purse A Transient receptor potential melastatin 8 channel involvement in the regulation of vascular tone Am J Physiol Heart Circ Physiol 2009 296 H1868 H1877 19363131
9 Namer B Seifert F Handwerker HO TRPA1 and TRPM8 activation in humans: effects of cinnamaldehyde and menthol Neuroreport 2005 16 955 959 15931068
11 Topp R Winchester LJ Schilero J Effect of topical menthol on ipsilateral and contralateral superficial blood flow following a bout of maximum voluntary muscle contraction Int J Sports Phys Ther 2011 6 83 91 21713232
12 Chotani MA Flavahan S Mitra S Silent alpha(2C)-adrenergic receptors enable cold-induced vasoconstriction in cutaneous arteries Am J Physiol Heart Circ Physiol 2000 278 H1075 H1083 10749700
13 Green DJ O'Driscoll G Blanksby BA Control of skeletal muscle blood flow during dynamic exercise: contribution of endothelium-derived nitric oxide Sports Med 1996 21 119 146 8775517
14 Ohta T Imagawa T Ito S Involvement of transient receptor potential vanilloid subtype 1 in analgesic action of methylsalicylate Mol Pharmacol 2009 75 307 317 18987162
15 Davis RE Wachholz JH Jassir D Comparison of topical anti-ischemic agents in the salvage of failing random-pattern skin flaps in rats Arch Facial Plast Surg 1999 1 27 32 10937072
16 Hong CZ Shellock FG Effects of a topically applied counterirritant (Eucalyptamint) on cutaneous blood flow and on skin and muscle temperatures: a placebo-controlled study Am J Phys Med Rehabil 1991 70 29 33 1994967
17 Kunta JR Goskonda VR Brotherton HO Effect of menthol and related terpenes on the percutaneous absorption of propranolol across excised hairless mouse skin J Pharm Sci 1997 86 1369 1373 9423148
20 Jones M Zhang F Blain B Influence of recipient-bed isolation on survival rates of skin-flap transfer in rats J Reconstr Microsurg 2001 17 653 658 11740663
21 Cheon YW Tark KC Kim YW Better survival of random pattern skin flaps through the use of epigallocatechin gallate Dermatol Surg 2012 38 1835 1842 22974425
22 Komorowska-Timek E Chen SG Zhang F Prolonged perivascular use of verapamil or lidocaine decreases skin flap necrosis Ann Plast Surg 1999 43 283 288 10490180
25 Ghavami A Nutt MP Hardy SP Heat shock protein and high-dose aspirin: effects on random skin flap survival in a rat model Ann Plast Surg 2002 48 60 67 11773732
※ AI-Helper는 부적절한 답변을 할 수 있습니다.