title: The effect of simvastatin on the survival of ischaemic skin flap: an experimental study in rats.
abstract: Thrombomodulin (TM) is down-regulated from the vascular endothelial surfaces and corresponds to disturbed dermal blood flow and microthrombus formation in the ischaemic skin flap. We examined the therapeutic potential of simvastatin which up-regulates endothelial cell TM expression and activity in the dorsal ischaemic skin flap model. The study was carried out on 30 rats, divided into three groups. Group 1 was treated with simvastatin at a dose of 5mgkg(-1) day(-1) by intraperitoneal injection. Group 2 was treated with 1mgkg(-1) day(-1) with a phosphate-buffered saline for 7 days. Group 3 was the control group. Tissue blood flow, vascularisation and the survival rate of the skin flaps from each group were compared. The mean surviving area of group 1 was higher than groups 2 and 3 (p<0.05). The blood flow change rate did not decrease in the treatment group in contrast to the control groups at 3cm and 5cm (p<0.05). Microangiography demonstrated decreased flap vascularity in groups 2 and 3. There was no evidence of necrosis or positive peroxidase staining for TM in group 1 at 3cm and 5cm., although it was negative in groups 2 and 3. In this study, it was demonstrated that simvastatin prevented shedding of endothelial TM and contributed to flap survival.
authors.affiliation: Department of Plastic and Reconstructive Surgery and Burn Unit, Gülhane Military Medical Academy and Medical Faculty, Haydarpaşa Training Hospital, Selimiye Mahallesi Tıbbiye Caddesi 34 668, Üsküdar, Istanbul, Turkey. fatihuygur@hotmail.com
authors.forename: Fatih
authors.initials: F
authors.lastname: Uygur
authors.forename: Nurettin
authors.initials: N
authors.lastname: Noyan
authors.forename: Aptullah
authors.initials: A
authors.lastname: Hahaolu
mesh_terms: D000792:Angiography / Q000379:methods; D000818:Animals; D006085:Graft Survival / Q000187:drug effects*; D007274:Injections, Intraperitoneal; D017078:Laser-Doppler Flowmetry; D008297:Male; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D019821:Simvastatin / Q000008:administration & dosage / Q000494:pharmacology*; D018709:Statistics, Nonparametric; D013524:Surgical Flaps / Q000098:blood supply*; D018180:Thrombomodulin / Q000378:metabolism
chemical_list: D018180:Thrombomodulin; D019821:Simvastatin