Deneysel sıçan modelinde iskemiye bağlı deri flep nekrozunda hemostatik ajan kullanım

Abstract

Aim: The uses of plant based hemostatic agents are increasing for obtaining operative field hemostasis. However, their effects on vascularly challenged tissue is not known. The aim of this study was to investigate the effect, if any, of plant-based hemostatic agent, Ankaferd (ABS) on flap viability in a rat model. Material and Methods: Twenty rats underwent McFarlane flaps under general anesthesia. Ten rats in Group I received no other treatment. Ten rats in Group II received ABS to the underside of flaps. Viable flap area was determined in scintigraphic images and percentage of viable flap area pixel size to the total flap area pixel size was calculated. Additionally all flap areas were digitally photographed and underwent histopathologic evaluation. Results: Scintigraphic analysis has shown limited viability at proximal pedicle zone of flap in Group II compared to Group I. The mean area of flap survival percentage was calculated in Group I and in Group II was as follows respectively 56.33 ±9.94%, 26.27±7.05%. Differences between groups were statistically significant (p<0.001). Similarly, Group II has shown significantly smaller area of viable tissue percentage compared to Group I (26.81±5.55%, versus 59.66±12.04%, p<0.001) by digital photographic analysis. Histopathologic results were significantly high in Group II compared to Group I (p<0.001) whereas neovascularization was significantly low in Group II compared to Group I (p<0.001). Conclusion: Despite its efficacy in surgical hemostasis, ABS use is associated with an increased incidence of distal tip necrosis in dorsal rat skin flaps. Therefore ABS use in marginally perfused tissues particularly in random skin flaps should be cautious.