| Objective To investigate the effect of natural hirudin which was applied locally to the vein congestion on ramdon pattern skin flap in a porcine model.Methods Three Guangxi Bama miniature pigs,including both male and female, aged 6 to 8 months old and with a body mass of 12.5±2.5Kg, were employed to establish congestive model. Six dorsal random pattern skin flaps (three on each) were elevated on each animal, with each flap measured by 14 cm×4 cm. According to the pharmacologic manipulations which were administered immediately after operation, 1st, 2nd, and 3rd day respectively, the eighteen flaps were divided randomly into 3 groups (six in each group): Group A(act as control group which was locally applied with isotonic Na chloride), Group B(locally applied 20ATU natural hirudin each flap), Group C(locally applied 40ATU natural hirudin each flap). Macroscopic observation (done on 1st and 10th day postoperatively), pathological section of the congestive tissue (done on 1st and 7th day postoperatively), the ratio of wet weight and dry weight of the congestive tissue (done on 3rd and 7th day postoperatively), the temperature of the surface of congestive flap (done on 5th day postoperatively) and local blood flow of the flap detected by Color Doppler Ultrasound (done on 7th day postoperatively) were examined.Results Macroscopic observation showed that congestion of the flaps in each group had no significance immediately after operation (P>0.05); on the 1st day postoperatively, the length of the congestion of the flap in group A (9.68±0.43cm) was significantly longer than group B (6.81±0.53cm) and group C (8.51±0.64cm) (P<0.05), while the length of which in group C was longer than group B (P>0.05); on the 10th day postoperatively, the length of the necrosis in the distal end of flap in group A and C were significantly longer than that of group B (P<0.05), while the length of which in group A was longer than group C (P>0.05). The histological observation revealed that the degree of erythrocyte agglutination in dermis capillary and veinule in group A was more severe than that of group B on the 1st day postoperatively, and there was little collagen and granulation tissue in group A compared with that of group B on the 7th day postoperatively. The ratio of wet weight and dry weight: on the 3rd day 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 significance between group B and C (P>0.05); on the 7th day postoperatively, the value in group A was significantly higher than that of group B and group C (P<0.05), and there was also no significance between group B and C (P>0.05). The temperature of the surface of the congestive flap was 36.64±0.70℃in group A, 38.61±0.42℃in group B and 37.50±0.46℃in group C on the 5th day postoperatively. The temperature of group A was significantly lower than that of group B and C (P<0.05), and there was no significance between group B and C (P>0.05). Local blood flow of the flap detected by Color Doppler Ultrasound on the 7th day showed that the images of blood flow was very little in group A, also, it revealed that the images of arterial blood flow can be detected in group C and that of venous return, even perforator artery, can be seen in group B.Conclusion Local application of natural hirudin had singnificant improvement to the congestion of ramdon pattern skin flap in a porcine model.
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