ABSTRACT
Stem cells are applied in the treatment of wide range of diseases and can be separated from different tissues of the body. These cells can treat diseases by cytokine and growth factor secretion and also cell differentiation. Burn wound is a challenging problem of reconstructive surgery and stem cells may help wound healing process. We designed this study to evaluate the beneficial effect of fat derived stem cells for coverage of 3[rd] degree burn wound. This study was experimental and has been done in Burn Research Center of Iran University of Medical Sciences during January 2012 to April 2013. Thirty rats randomly divided to three equal groups. Inguinal fat of 10 rats [one group] were used for preparation of autologous adipose-derived mesenchymal stem cells. Acellular amnion was used as a scaffold for stem cell transfer. Each of the thirty rats had been exposed to a cm deep 3rd degree burn on back area. 24 hours after surgery, the wound was excised and it had been covered by three conventional dressing in the first group, acellular amnion in the second group and acellular amnion seeded with adipose-derived stem cell in the third group. The rate of wound healing and pathologic characteristics was compared in all three groups. Healing rate and decrease in wounds size was significantly better in acellular amnion seeded with adipose- derived stem cells compared with other two groups at 3[rd] and 15[th] days after surgery P<0.01. Also in histopathology examination, fibroplasia and neovascularization of wounds were significantly better in stem cells group than the other two groups P<0.001. Acellular amnion seeded with adipose-derived stem cell can result in faster wound healing and better histopathology characteristic. The amnion as a scaffold and the fat derived stem cells as healing accelerator are recommended for coverage of the 3rd degree burn wounds after excision and it may reduce the need for skin graft
ABSTRACT
Thumb is with a special role in hand function. Therefore, in addition to the significance of using thin, pliable, color-matched, and hairless cover in resurfacing the lesion in this area, recovery of sensation should also be taken into consideration. Thirteen patients with thumb degloving injuries were candidates for sensate reverse island radial forearm surgery. After transferring the flap, forearm lateral sensory nerve was sewn to the thumb digital nerve. At least for two years, these patients received regular diagnosis, and monofilament, static two point discrimination [S- 2PD], and moving two point discrimination [M-2PD] tests were taken from them. Monofilament test did not show normal sensation recovery, at protective sensation threshold, in the parents. The difference between monofilament test and normal thumb was statistically significant [p<0.0001]. In spite of this, the protective sensation was restored in all flaps after two years. According to the results from S-2PD and M-2PD tests, the restored sensation was at protective threshold or reduced, and the difference was statistically significant [p<0.0001]. Given difficulties of performing free flaps, and also deficiencies of pedicle flaps, the forearm radial island flap is known as one of the primary choices in most of the thumb soft tissue and hand defects reconstruction, due to its advantages, especially restoring the sensation of the injured site
ABSTRACT
Autograft is the best option in nerve defects when end-to-end repair can not sufficiently preserve nerve continuity. Theoretically, if the severed nerve is reversely grafted, it may prevent axonal growth into nerve branches, and larger amounts of axons will reach the target organ and more satisfactory results will be obtained. In this study we aimed to compare conventional versus reverse nerve grafting. This study was performed in Animal laboratory of Hazrat Fatemeh Hospital from April till August 2011. We randomly divided 40 Wistar rats into two groups. We excised 1.5 cm of the right sciatic nerve and anastomosed it conventionally between the proximal and distal ends of the nerve in rats in group A and in a reverse manner in rats in group B. The rats' footprints were recorded in the first and 16[th] weeks after surgery. In week 16, the grafted nerves were removed under anesthesia for pathological examination and axon count. Subsequently, the results were compared clinically by sciatic functional index [SFI] through footprint analysis and paraclinically by axon count. A p-value smaller than 0.05 was considered statistically significant. Conventional and reverse nerve grafting no had statistically significant differences in clinical assessment in the first and 16[th] weeks [P=0.87] post-surgically and also no difference in paraclinical assessment in week 16 [P=0.68]. We had no significant clinically or para clinically differences between two approaches. It should be considered that the diameter and length of nerves and muscles in human is larger than rats, so the results of nerve repair may differ in human. We suggest a study in animal model which is anatomically more similar to human
Subject(s)
Animals, Laboratory , Peripheral Nerves/surgery , Autografts , Extremities , Rats, Wistar , Transplantation, Autologous , Sciatic Nerve , DNA Footprinting/veterinaryABSTRACT
Random pattern flap is a common reconstructive surgery procedure but its necrosis is a challenging problem. A lot of pharmacological agents and surgical procedures have been examined for the prevention of this complication to maximize the length to width ratio of these surgical flaps. Therefore, we designed an experimental study to evaluate the effects of aspirin, clopidogrel bisulfate [Plavix] and their combination on random skin flap survival in rats. Forty male rats were randomly assigned to four equal groups. Surgery was done under general anesthesia. A random, rectangular 3x11 cm dorsal skin flap was designed, elevated and sutured back into its primary site. In group one, 100 mg/kg Aspirin and in group two, 25 mg/kg Plavix were administered orally for 7 days postoperatively. Aspirin and Plavix were co-administered in the third group for the same period of time while the control group received no medication. After 7 days, the total surface of flaps, the viable and also the necrotic parts were measured by Image J software. Mean standard deviation and analysis of variance were calculated to compare the results. The mean area of flap survival was 62.49% in the control, 64.04% in Aspirin, 65.09% in Plavix and 64.06% in combination groups. No statistically significant differences were found between treatment groups and control rats. In this study, we found no significant differences between Aspirin, Plavix or their combination on the survival of random skin flaps.
ABSTRACT
Necrosis of skin flaps is considered as an important complication in reconstructive surgery. We conducted an experimental study to investigate the efficacy of low-molecular weight heparin, clopidogrel and their combination to improve the flap survival. Forty male, adult Sprague-Dawlay rats were divided randomly into 4 groups. Standard rectangular, distally based dorsal random pattern skin flap was elevated. To prevent the graft effect, a sterile sheet was put under the flap. No pharmacological agent was administered for the control group. In group 2, single subcutaneous dose of enoxaparin [3.2 mg/kg] was immediately administrated after surgery. In group 3, clopidogrel [25 mg/kg] was given orally for 7 days. In group 4, both enoxaparin and clopidogrel were administrated. The rats were evaluated on post-operative day 7 for viable and necrotic portions of flaps. The mean and SD of necrosis was 17.79 +/- 2.5 cm in the control group, 16.20 +/- 3.1 cm in low-molecular weight heparin, 15.25 +/- 3.8 cm in combined therapy group and 13.69 +/- 2.7 cm in clopidogrel group. Clopidogrel was the only pharmaceutical agent that produced a significant increase in the flap survival area. Clopidogrel may be an effective pharmaceutical agent that significantly increases viability of random skin flaps in rats, but low-molecular weight heparin and their combination did not have any significant beneficial effects