title: [Experimental study on enhancement of tissue expansion with papaverine cream].
abstract: OBJECTIVE
  To evaluate the effect of external use of papaverine cream on enhancement of tissue expansion.
  
  
  METHODS
  8 mini pigs were randomly divided into 4 groups. During inflation, papaverine was given externally in group A, through a delivery system in group B, though intramuscular injection in group C. Papaverine was not given in group D. The time of inflation, the expansion rate, the surviving length of expanded flaps and the papaverine concentration in the fibrous capsule in each group were examined. Histologic and electroscope examinations of the expanded tissue were made.
  
  
  RESULTS
  The average inflation time was 28.9 +/- 4.5 days in group A, 34.0 +/- 2.6 days in group B, 37.6 +/- 4.8 days in group C and 38.5 +/- 3.5 days in group D. There was significant difference between each group(P < 0.05). The average surviving length of expanded flaps in group A was 13.67 +/- 1.28 cm, 11.07 +/- 0.88 cm in group B, 10.79 +/- 0.49 cm in group C, and 9.49 +/- 0.77 cm in group D. There was significant difference between each group (P < 0.01). Histologic examinations of the expanded tissue suggested that there were no significant differences in thickness of epidermis, derma and fibrous capsule among the four groups. Electroscope examinations of the myofibroblast in fibrous capsule showed that there were smaller nuclei, fewer microfilaments and fewer mitochondrias and rougher endoplastic reticulume in group A than those in other groups. The concentration of papaverine in fibrous capsule of group A was 3.5 +/- 1.2 micrograms/g. Papaverine was detected neither in the skin of other groups nor in the blood of all groups.
  
  
  CONCLUSIONS
  1. Papaverine cream can permeate through skin and maintain high concentration and continuous effect in local tissue. 2. External use of papaverine cream can inhabit the function of myofibroblast in fibrous capsule, increase inflation rate, accelerate expansion process, and improve microcirculation of the expanded skin with a result of prolongation of surviving length of expanded flaps. 3. The technique of enhancing tissue expansion with external use of papaverine has the advantages of convenient delivery, cheapness, no more injury and infection, and no side effects etc. It is a safe, effective, simple, and reliable method for accelerating tissue expansion.
authors.affiliation: Plastic Surgery Hospital, Chinese Academy of Medical Science, Beijing 100041, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Luan
authors.forename: Yong
authors.initials: Y
authors.lastname: Tang
authors.forename: Peiying
authors.initials: P
authors.lastname: Yang
authors.forename: Xuhui
authors.initials: X
authors.lastname: Zhang
authors.forename: Dianju
authors.initials: D
authors.lastname: Hou
authors.forename: Guie
authors.initials: G
authors.lastname: Ma
authors.forename: Qian
authors.initials: Q
authors.lastname: Wang
mesh_terms: D000818:Animals; D010208:Papaverine / Q000008:administration & dosage* / Q000493:pharmacokinetics; D012867:Skin / Q000187:drug effects; D013524:Surgical Flaps; D013552:Swine; D013556:Swine, Miniature; D013997:Time Factors; D015626:Tissue Expansion; D014665:Vasodilator Agents / Q000008:administration & dosage*
chemical_list: D014665:Vasodilator Agents; D010208:Papaverine