Effects of Botulinum Toxin Type A on the Axial Skin Flap Survival.

BACKGROUND: A suitable pharmacological substitute for the well-established surgical delay technique for axial skin flaps regarding increasing viability is elusive. We aimed to evaluate the effects of botulinum toxin type A (BTA) on the axial skin flap survival in a rat model. METHODS: The present controlled experimental study was performed in Kerman University of Medical Science, Kermanshah, Iran during 2016-2017 on three groups of rats. Group 1 (control group) had no preconditioning while Groups 2 and 3 were preconditioned by the intradermal injection of normal saline (0.5 ml) in the cephalic end of the skin flap and the injection of the BTA (1.6 units Neuronex) reconstituted in normal saline, respectively. Two weeks after this intervention in each group, the flap was raised and kept in situ and a biopsy was simultaneously taken for evaluating neoangiogenesis, followed by evaluating flap necrosis after two weeks of following-up by photography. RESULTS: Although BTA induced angiogenesis significantly, it failed to reduce the area of necrosis compared to the other groups. CONCLUSION: BTA was effective in increasing angiogenesis in the axial skin flap although it was unable to reduce necrosis.

The Effect of Cell-Deprived Platelet Lysate Growth Factors (PLGF) on the Perichondrium Preserved Cartilage Graft Viability.

BACKGROUND: Finding a suitable pharmacological substance and a surgical method for improving cartilage graft preparation are necessary. This present study was planned to evaluate the effects of PLGF and graft preparation methods on cartilage graft survival. METHODS: This controlled, experimental study was performed in Kerman University of Medical Science, Kerman, Iran during 2016- 2017 on two groups of rabbits. Group 1 received PLGF (PLGF +) while Group 2 did not receive any PLGF (PLGF -). In each group, three carilage graft preparation methods including Block Cartilage Graft (BCG), Diced Cartilage Graft (DCG), and Crashed Cartilage Graft (CCG) were used. Three months after the intervention, the grafts were re-assessed and weighed. A specimen from each graft was taken for inflammation, fibrosis, necrosis, and viable chondrocyte. RESULTS: The CCG method had the maximum ossification percentage (OS%) and no change occurred by PLGF. The BCG method had the greatest viable chondrocyte number, attenuated by PLGF. The BCG method had the highest amount of fibrosis, without any change by PLGF. Additionally, the inflammation percentage and necrosis in the PLGF + group were greater than the PLGF - group. CONCLUSION: The most important effecting factor on the properties of cartilage graft is the method of graft preparation and PLGF only attenuates the methods properties without changing them.

A Giant Solid-Cystic Mesenteric Fibromatosis with Unusual Synchronous Skin Fibromatosis.

Mesenteric fibromatosis (MF) is a rare, locally aggressive tumor without distant metastasis, which has a high recurrence rate. Based on its location, it is classified as intra-abdominal, from abdominal wall, and extra-abdominal. The incidence of cystic-solid, retroperitoneal tumors is very low in comparison to other MF forms. Intra-abdominal MFs are asymptomatic in early stages, but their symptoms appear late in the tumor course. There is no specific imaging finding since radiological diagnosis is mostly impossible. Thus, diagnosis is made histopathologically. Nowadays, there is no consensus about its treatment although surgical resection is widely used. In the present study, a very rare case of cystic-solid retroperitoneal MF associated with separate synchronous skin tumors is reported.

Montelukast for Medical Delay in Flap Surgery.

BACKGROUND: Delay phenomenon can be used for better blood supply of the flap in plastic surgery. Effects of Montelukast have been observed to reduce ischemia/reperfusion injury in various organs due to angiogenic and anti-oxidant effects. The present study aimed to determine the role of Montelukast as medical delay of the flaps. METHODS: In this experimental study, 42 Wistar rats were divided into 3 equal groups. These groups were Surgical Delay Group (SDG), Medical Delay Group (MDG) and Control Group (CG). In SDG, 8×3 cm rectangular randomized random skin flap was first surgically delayed at rats' back. The MDG received 10 mg/kg oral Montelukast via orogastric tube for 5 days as medical delay. In MDG and SDG flap, harvesting was undertaken after a delayed period, but there was not any delayed period in CG. After delayed period, a segment of the skin flap was biopsied for assessing angiogenesis. After 14th days, the photos were taken and the size of the necrotic area of the flap was measured. RESULTS: A significant difference was observed between the mean survival and angiogenesis (p=0.002). The same performance was reported between MDG and SDG, which were alike regarding survival and angiogenesis (p>0.05); while there was a significant difference between the control and surgical groups, as well as control and medical groups (p<0.05). Finally, the inflammation showed no significant difference (p>0.05). CONCLUSION: Regarding positive effects of Montelukast on survival and angiogenesis, it is recommended to be used as a medication for larger studies.

Bone marrow mesenchymal stem cell and vein conduit on sciatic nerve repair in rats.

BACKGROUND: Peripheral nerve repair with sufficient functional recovery is an important issue in reconstructive surgery. Stem cells have attracted extensive research interest in recent years. OBJECTIVES: The purpose of this study was to compare the vein conduit technique, with and without the addition of mesenchymal stem cells in gap-less nerve injury repair in rats. MATERIALS AND METHODS: In this study, 36 Wistar rats were randomly allocated to three groups: In the first group, nerve repair was performed with simple neurorrhaphy (control group), in the second group, nerve repair was done with vein conduit over site (vein conduit group) and in the third group, bone marrow stem cells were instilled into the vein conduit (stem cell group) after nerve repair with vein conduit over site. Six weeks after the intervention, the sciatic function index, electrophysiological study and histological examination were performed. RESULTS: All animals tolerated the surgical procedures and survived well. The sciatic function index and latency were significantly improved in the vein conduit (P = 0.04 and 0.03, respectively) and stem cell group (P = 0.02 and 0.03, respectively) compared with the control group. No significant difference was observed in sciatic function and latency between the vein conduit and stem-cell groups. Moreover, histological analysis showed no significant difference in regenerative density between these two groups. CONCLUSIONS: The results of this study showed that the meticulous microsurgical nerve repair, which was performed using the vein tubulization induced significantly better sciatic nerve regeneration. However, the addition of bone marrow mesenchymal stem cell to vein conduit failed to promote any significant changes in regeneration outcome.

The healing effect of nettle extract on second degree burn wounds.

BACKGROUND: Numerous studies were carried out to develop more sophisticated dressings to expedite healing processes and diminish the bacterial burden in burn wounds. This study assessed the healing effect of nettle extract on second degree burns wound in rats in comparison with silver sulfadiazine and vaseline. METHODS: Forty rats were randomly assigned to four equal groups. A deep second-degree burn was created on the back of each rat using a standard burning procedure. The burns were dressed daily with nettle extract in group 1, silver sulfadiazine in group 2, vaseline in group 3 and without any medication in group 4 as control group. The response to treatment was assessed by digital photography during the treatment until day 42. Histological scoring was undertaken for scar tissue samples on days 10 and 42. RESULTS: A statistically significant difference was observed in group 1 compared with other groups regarding 4 scoring parameters after 10 days. A statistically significant difference was seen for fibrosis parameter after 42 days. In terms of difference of wound surface area, maximal healing was noticed at the same time in nettle group and minimal repair in the control group. CONCLUSION: Our findings showed maximal rate of healing in the nettle group. So it may be a suitable substitute for silver sulfadiazine and vaseline when available.

Assessing effect of three herbal medicines in second and third degree burns in rats and comparison with silver sulfadiazine ointment.

INTRODUCTION: Assessing effect of three herbal medicines on healing of deep second and third degree burns in rats and their comparison with silver sulfadiazine group. METHODS AND MATERIALS: 40 rats were randomly assigned to one of the four groups, each group 10 rats. A deep second degree burn and a third degree burn were induced on the lower back and upper back of each rat under standard burning procedure, respectively. The burns were daily dressed with Robacin in group 1, silver sulfadiazine in group 2, aloe vera extract in group 3, and Rimojen in group 4. Responses to the treatment were assessed by digital photography during the treatment until day 32. Histological parameters (PMN, epithelialization, fibrosis, and angiogenesis) were assessed after the scar biopsy at the end of the research. RESULTS: On the basis of the taken photos, the wound had better healing in Robacin group. Also, speed of healing was better in aloe vera group than silver sulfadiazine and Rimojen groups. In terms of wound surface area maximal improvement was observed at the same time in the second and third degree burn wounds in Robacin group, in the second degree wound of aloe vera and Rimojen groups, and in the third degree wound of aloe vera and silver sulfadiazine groups. In pathological respects, epithelialization was more evident in both wounds of aloe vera group and third degree burn of Robacin group. In both wounds of Robacin group (second and third degree), the extend of angiogenesis and fibrosis was significantly less than other groups; but, inflammation was at a less level in third degree of silver, second degree of Rimogen and aloe vera, and third degree of aloe vera groups. CONCLUSION: In histological survey, minimal rate of angiogenesis and fibrosis was seen in Robacin group, which indicated less wound scar in this group. Healing speed of the burn wound was also higher in Robacin group.