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  • Title: [Experimental study on effect of natural hirudin on vein congestion of random skin flap in porcine models].
    Author: Sun Z, Wang G, Yang X, Yang J, Teng X, Yin G.
    Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2008 Nov; 22(11):1296-300. PubMed ID: 19068593.
    Abstract:
    OBJECTIVE: To investigate the effect of natural hirudin which is applied locally on vein congestion of random pattern skin flap in porcine models. METHODS: Three Guangxi Bama miniature pigs, including male and female aged 6-8 months and weighing 10-15 kg, were employed to establish animal model of vein congestive. Six dorsal random pattern skin flaps (three on each side) were prepared on each animal, 14 cm x 4 cm in size. According to the pharmacologic manipulations which were administered immediately and at 1, 2, and 3 days after operation respectively, the eighteen flaps were divided randomly into 3 groups (six in each group). In group A, isotonic Na chloride was locally applied as control group. In group B, 3 mL of 20 ATU natural hirudin was locally applied at each flap. In group C, 3 mL of 40 ATU natural hirudin was locally applied at each flap. Macroscopic observation (at 1 and 10 days postoperatively) and histological observation (at 1 and 7 days postoperatively) were made, the ratio of wet weight to dry weight of the congestive tissue (at 3 and 7 days postoperatively), the temperature of the surface of congestive flap (at 5 days postoperatively) and local blood flow of the flap (by Color Doppler Ultrasound at 7 days postoperatively) were measured. The survival rate of skin flaps was determined at 12 days postoperatively. RESULTS: Macroscopic observation showed that congestion of the flaps had no significance among three groups immediately after operation (P > 0.05); at 1 day postoperatively, the length of the congestion of the flap in group A (9.68 +/- 0.43) cm was significantly longer than that in group B (6.81 +/- 0.53) cm and group C (8.51 +/- 0.64) cm (P < 0.05), while there was no significant difference between group B and group C (P > 0.05); at 10 days postoperatively, the necrosis at the distal end of flap in group A and group C were significantly longer than that in group B (P < 0.05), while there was no significant difference between group A and group C (P > 0.05). The histological observation revealed that the degree of erythrocyte agglutination in dermis capillary and venule in group A was more serious than that of group B at 1 day postoperatively, and there was little collagen and granulation tissue in group A when compared with group B at 7 days postoperatively. The ratio of wet weight to dry weight: at 3 days postoperatively, the value in group A (3.94 +/- 0.14) was significantly higher than that of group B (3.43 +/- 0.14) and group C (3.60 +/- 0.19) (P < 0.05), and there was no significant difference between group B and group C (P > 0.05); at 7 days postoperatively, the value in group A (3.61 +/- 0.11) was significantly higher than that of group B (3.08 +/- 0.13) and group C (3.34 +/- 0.21) (P < 0.05), and there was no significant difference between group B and group C (P > 0.05). The surface temperature of the congestive flap was (36.64 +/- 0.70) degrees C in group A, (38.61 +/- 0.42) degrees C in group B and (37.50 +/- 0.46) degrees C in group C at 5 days postoperatively; showing significant difference between group A and groups B, C (P < 0.05), and no significant difference between group B and group C (P > 0.05). The Color Doppler Ultrasound showed that the image of blood flow was very little in group A, the image of venous return and perforator artery could be seen in group B and the image of arterial blood flow could be detected in group C. The survival rate of skin flaps was 45% +/- 7% in group A, 67% +/- 4% in group B and 52% +/- 4% in group C at 12 days postoperatively; showing statistically significant difference between groups B, C and group A (P < 0.05), but no statistically significant difference between group B and group C (P > 0.05). CONCLUSION: Local application of natural hirudin can significantly improve the congestion of random pattern skin flap in a porcine model.
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