Summary
Objective
Random-pattern skin flaps are used widely in plastic surgery, but necrosis resulting
from ischaemia in the distal sections of the flap is a serious problem. Free oxygen
radicals and the accumulation of increased neutrophil granulocytes play important
roles in tissue injury and may lead to partial or complete necrosis of the flap. Amniotic
membrane is a biomaterial used widely in clinical settings to prevent the infiltration
and activation of leucocytes. The aim of this study was to test the effects of amniotic
membrane on the survival of ischaemic skin flaps in rats.
Methods
A total of 32 male rats were divided randomly into four groups of eight, according
to the procedure to be tested: flap-only (F), flap-amniotic membrane (FA), flap-Tegaderm® (FT) and flap-amniotic membrane-Tegaderm® (FAT).
Rectangular, random-pattern, caudally based modified McFarlane skin flaps were elevated
at the dorsum of the rats in all four groups. The flap-only group was also the control
group; in this group, the flaps were elevated and sutured to their native position.
In the FA group, after the flaps were elevated, the amniotic membrane was inserted
underneath the undersurface of the flap. In the FT group, after the flaps were elevated,
a piece of Tegaderm was inserted underneath the undersurface of the flap. In the FAT
group, the amniotic membrane was inserted underneath the undersurface of the flap
and the Tegaderm® was inserted in the flap donor area. The survival rate of the skin flaps was measured
on day 7, and histologic assessments were performed.
Results
The survival rate of the skin flaps was significantly improved in the FA and FAT groups
(67–69%, p < 0.05) compared with the F and FT groups (46–48%, p < 0.05). Histologic analysis showed many more blood vessels and fewer neutrophils
in the FA and FAT groups than in the F and FT groups.
Conclusion
This study showed that amniotic membrane could improve the survival rate of ischaemic
skin flaps.
Keywords
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Article info
Publication history
Published online: July 09, 2012
Accepted:
June 11,
2012
Received:
August 10,
2011
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
