title: The Effect of Thrombolytic, Anticoagulant, and Vasodilator Agents on the Survival of Random Pattern Skin Flap.
abstract: BACKGROUND
  The aim of this study was to investigate the effect of subcutaneously applied thrombolytic, anticoagulant, and vasodilator agents on the survival of random-pattern skin flap.
  
  
  METHODS
  A caudally based dorsal flap model was used in 24 rats in four groups. In group 1 (n = 6), flap was elevated and sutured. In group 2 (n = 6), enoxaparin sodium was injected subcutaneously immediately after surgery, on days 1 and 2. In group 3 (n = 6), a transdermal nitroglycerin was applied directly following surgery, on days 1 and 2. In group 4 (n = 6), alteplase was injected subcutaneously immediately after surgery, on days 1 and 2. Blood flow was measured with laser Doppler flowmetry at the proximal and distal halves of flap before, immediately after surgery, and on days 3 and 7. Histologic samples were taken from the same locations on day 3 and day 7 postoperatively. Vessel and lymphocyte count was obtained. Photographs were taken to determine flap necrosis areas at day 7 postoperatively.
  
  
  RESULTS
  Area of skin necrosis was found to be less in all medication groups. But only enoxaparin sodium group showed significant decrease in skin necrosis (p < 0.05). Laser Doppler flowmetry showed a gradual decrease in all groups over time, with no statistically significant result. The histologic findings revealed the induction of angiogenesis in all experimental groups.
  
  
  CONCLUSIONS
  Subcutaneously applied thrombolytic, anticoagulant, and vasodilator agents increase random-pattern skin flap survival with only enoxaparin sodium showing significant decrease in flap necrosis.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Mübin
authors.initials: M
authors.lastname: Aral
authors.affiliation: Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Serhan
authors.initials: S
authors.lastname: Tuncer
authors.affiliation: Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Ayşe
authors.initials: A
authors.lastname: Şencan
authors.affiliation: Department of Histology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Çiğdem
authors.initials: Ç
authors.lastname: Elmas
authors.affiliation: Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Sühan
authors.initials: S
authors.lastname: Ayhan
mesh_terms: D000818:Animals; D000925:Anticoagulants / Q000494:pharmacology*; D005343:Fibrinolytic Agents / Q000494:pharmacology*; D006085:Graft Survival / Q000187:drug effects*; D008297:Male; D023421:Models, Animal; D009336:Necrosis; D051381:Rats; D017208:Rats, Wistar; D012867:Skin / Q000098:blood supply / Q000187:drug effects; D013524:Surgical Flaps / Q000098:blood supply*; D014665:Vasodilator Agents / Q000494:pharmacology*
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D014665:Vasodilator Agents