ABSTRACT
Objective@#To investigate the effects and related mechanism of bivalirudin on the survival of random skin flap on the back of rat.@*Methods@#Thirty SD rats were divided into bivalirudin group and normal saline group according to the random number table, with 15 rats in each group. The random flap model with size of 9 cm×3 cm was reproduced on the back of rats in two groups. Immediately post injury, rats in bivalirudin group were intraperitoneally injected with 5 mg/mL bivalirudin (0.8 mL/kg), while rats in normal saline group were intraperitoneally injected with normal saline (0.8 mL/kg) once a day. The continuous injection lasted for 7 days. The flap was divided into distal area, middle area and proximal area averagely based on the flap blood supply. On post injury day (PID) 1, 3, and 7, the overall survival of each area of flap was observed with naked eyes. On PID 7, the survival rate of flap was calculated, and then the morphology of skin tissue at the center of the three areas of flap was observed by HE staining, the microvessel density (MVD) of the middle area of flap was calculated, and the expression of vascular endothelial growth factor (VEGF) of the middle area of flap was detected with immunohistochemical staining. Data were processed with t test.@*Results@#(1) On PID 1, flaps of rats in two groups had different degrees of swelling, mainly concentrated in distal area, but there was no obvious necrosis. The middle area and proximal area of flaps in two groups were survived. On PID 3, the necrosis of flaps of rats in two groups was concentrated in the middle area, while the proximal area of flap was still in survival state, and most distal area of flap was necrosis with a little scab. On PID 7, the necrosis of middle area of flaps of rats in two groups was gradually fused, and the survival area of flap of rats in bivalirudin group was larger than that in normal saline group. The distal area of flap was almost necrotic, and the proximal area of flap was almost survived. (2) On PID 7, the survival rate of flap of rats in bivalirudin group was (64±4)%, significantly higher than that in normal saline group [(45±3)%, t=13.49, P<0.01]. (3) On PID 7, the histological morphology of distal area of flap of rats in two groups was similar, the inflammatory cells were infiltrated abundantly, and tissue edema was obvious. A large number of new blood vessels appeared in the middle area of flap of rats in bivalirudin group, with the formation of collateral vessels, and basic dilation of new blood vessels was seen. There were fewer new blood vessels appeared in the middle area of flap of rats in normal saline group, and dilation of new blood vessels was not obvious. There was little inflammatory cells infiltration in the proximal area of flap of rats in two groups. Compared with that in normal saline group, tissue edema extent of proximal area of flap of rats in bivalirudin group was less, and expansion was observed in more blood vessels. (4) The MVD of middle area of flap of rats in bivalirudin group was (26±5)/mm2, significantly higher than that in normal saline group [(18±3)/mm2, t=5.43, P<0.05]. (5) The expression of VEGF of middle area of flap of rats in bivalirudin group was 6 534±384, significantly higher than that in normal saline group (4 659±448, t=12.31, P<0.05).@*Conclusions@#Bivalirudin can promote the survival of random skin flap in rats, and the mechanisms may include reducing the formation of thrombosis, improving the blood supply of flap, and increasing the expression of VEGF, promoting the formation of new blood vessels.
ABSTRACT
<p><b>OBJECTIVE</b>To observe the effects of Ixeri sonhifolia injection on random skin flap survival in rats.</p><p><b>METHODS</b>Dorsal full-thickness skin flap model were harvested from 24 Sprague-Dawley rats in 2 to 3 months old. Twelve rats in experimental group were injected intraperitoneally with 5 ml/kg Ixeri sonhifolia injection immediately after the operation, the other rats in control group with an equal volume of saline. The rats were killed by cervical dislocation after 7 days' Ixeri sonhifolia injection. The area ratio of the survival tissue was measured at the 7th day,the tissue samples from proximal, middle, and distal portions were stained by HE and sectioned for histological and image analysis. VEGF was detected by immunohistochemistry.</p><p><b>RESULTS</b>Seven days later, there was statistical significance between the percentage of the survival area of the flap between the experimental group (70.432 +/- 3.867)% and the control group (50.498 +/- 2.346)% (P < 0.05). In the middle portion, edema and infiltration of tissue in the experimental group were reduced than those of the control group, and new blood vessels increased in the experimental group (P < 0.05). A statistical significance of the expression of VEGF was detected between experimental group (4867.31 +/- 452.36) and control group (2387.45 +/- 768.46) (P < 0.05).</p><p><b>CONCLUSION</b>Ixeri sonhifolia injection can promote the survival of random skin flap by increasing the quantity of capillary, reducing inflammatory infiltration of Europhiles and increasing the expression of VEGF, which promote a new approaching for the transpanting of the random flap research.</p>