Surveying the effect of prophylactic topical oleic acid on survival of random skin flap in rabbits

Cutaneous flaps are frequently used in plastic surgery and ischemic necrosis is still a complication as a clinical problem. Different methods have been attempted in order to enhance flap survival including: hyperbaric oxygen, angiogenesis therapy [FGF, VEGF], pharmacologic agents such as sympatholitic, vasodilators, calcium channel blockers, hormonal agents, prostaglandin inhibitors, anticoagulants, oxygen-derived free radical scavengers, corticosteroids, delayed flap surgery, etc. In an experimental study it has been observed that topical application of oleic acid postoperatively on random skin flap increases survival of the flap. We have investigated the effect of prophylactic use of oleic acid on the survival of the rabbits' random skin flap. A total of 46 adult white New Zealand rabbits having a 3_10.5cm dorsal thoracic skin flap were selected. Flaps were assigned in 3 groups: for the first group topical oleic acid 75% [10% by volume] was applied ipsilaterally, while for the second group it was applied contralaterally and in the third group [control] the dorsal flap was treated with a basic ointment [a medical pure Vaseline]. Having elevated each flap, it was sutured into its bed. On the 6[th] postoperative day, area of flap survival was measured based on clinical evaluation. The average of total skin flap survival was 11 cm[2] in the first, 13.2 cm[2] in the second [p=0.65], and 20.7cm[2] in third group [control] [p < 0.05]. Although skin flap survival increases when topical oleic acid is used after surgery and flap elevation, prophylactic use of topical oleic acid decreases flap survival in the rabbits'random skin flap

Reversed sural flap for coverage of heel defect following marjolin's ulcer on frostbite

Marjolin's ulcer following frostbite is a rare occurrence. Our review of literature revealed that only 23 cases have been reported. In most instances heel is involved and the most common associated malignancy is squamous cell carcinoma. We present a 69-year-old male patient with squamous cell carcinoma arising over a frostbite scar in heel 45 years after cold injury. This case is unique with respect to the treatment modality performed: resection of tumor with free margins and reconstruction with pedicled reverse sural flap with good result and no evidence of recurrence during the follow up period