The Effect of Topical Application of Heparin with Microneedling on Skin Flap Survival

ABSTRACT

PURPOSE: The objective of this study is to evaluate the heparin effect for a viability of random-pattern dorsal flap in hairless mouse. METHODS: A caudally-based random dorsal flap, measuring 1.5 x 5 m, was designed and heparin was applied topically after microneedling. Twenty five male hairless mice were randomly divided into five groups control (Group 1, n=5); received only microneedling (Group 2, n=5), only heparin (Group 3, n=5), microneedling with saline (Group 4, n=5), and microneedling with heparin group (group 5, n=5) to the flap during 7 days. The number of the capillaries were compared between the experimental groups and control group with respect to neovascularization after heparin application using imaging analysis program under hematoxylin-eosin stain. The capillary blood flow was measured by laser Doppler flowmetry. After seven days each animal was evaluatedfor the percentage area of the flap survival. Mann- Whitnety U test and Kruskal-Wallis statistical analysis of survival relationships was performed. RESULTS: It can be observed increased number of the blood vessels in the experimental groups however it was not statistically significant. Blood flow of the haparin with microneedling group maintained higher than other experimental groups. Treated microneedling and heparin mice were significantly better flap viability than in controls (flap survival 67% and 54.4 mm2 respectively; p< 0.01). Positive correlation was shown between flap survival rate and laser Doppler flux value only at first day after surgery. CONCLUSION: Heparin has a beneficial effect on capillary flow and improve peripheral circulatory disturbances in random pattern flaps.