| Object:to investigating the effects of Mailuoning and Dexamethason on the survival of the ischemic random pattem flaps in rats and discussing some possible mechanis which contribute to the surviving of the flaps.Methods:Forty-eight male Sprague-Dawley rats were used in the study.The rats were divided into four groups of twelve each:control group,Dexamethasone group,Mailuoning group and Dexamethasone+Mailuoning group.A dorsal random pattem skin flap,measuring 15×70 mm2 was symmetrically raised.In the control group,3ml of 0.9%saline was injected into the abdominal cavity after the operation and at the 2nd to 7th day.In the Dexamethasone group,5mg/(kg·d ) of Dexamethasone was injected in the same way.In the Mailuoning group,15g/(kg·d) of Mailuoning was injected in the same way.In the Mailuoning+Dexamethasone group 15 g/(kg·d) of Mailuoning and 5mg/(kg·d) of Dexamethasone was injected in the same way.The NOS,SOD and MDA contents in the flap were examined 24h after operation,and the length of survival flap in the 4 groups were examined 7d after operation,Calculat the survival rate.Observed the layers of the structure and inflammatory cell infiltration.The changes of the capillary infused with Chinese ink were observed.Results:the NOS,SOD and MDA in Dexamethasone,Mailuoning, Dexamethasone+Mailuoning group was 0.21±50.49 35.19±0.48 and 21.08±1.37; 0.29±0.42,44.17±1.57 and 4.97±50.57;0.35±0.49,47.84±2.79 and 14.69±1.35; 0.69±1.67,60.24±2.43 and 3.31±0.18.Tissues survival rate of the four groups were 51.82±7.32%,65.59±3.47%,70.43±3.23%,79.37±5.69(P＜0.05).MVD in each group was 17.38±1.35,20.14±3.29,32.67±6.43 and 37.94±6.21(P＜0.05).HE stained groups were observed,in the control group the organizational structure has collapsed,the skin has clear atrophy,edema,inflammatory infiltration.In dexamethasone group,mild keratosis and subcutaneous edema.In the meluoling group,skin integrity,there is no subcutaneous edema and congestion,mild inflammatory cell infiltration.In the meluoling+dexamethasone group,skin integrity,there is no shrinking,hyperkeratosis and edema,in the dermal and subcutaneous there is no obvious infiltration of inflammatory cells.Electron microscopy check was used,in the control group,the capillary endothelial cells in the membrane partial was discontinuity,the mitochondrial has vacuolation,we can see that the rough endoplasmic reticulum has degranulation,ribosomal reduced,cytosolic degeneration,and the endoplasmic reticulum pool expansion.there is no new collagen and mature collagen,the platelet has a aggregation and thrombosis.In dexamethasone group capillary endothelial cells membrane was continuous,no swelling,the rough endoplasmic reticulum has local degranulation phenomenon,there is many intracellular micro filaments and rich ribose body,there is a large number of lysosomes and Golgi complex in the fibroblast.In the meluoling group,there is more capillary vascular structure of normal endothelial cells,there is abundant chromatin and cytoplasm.the cell membrane was integrity,there is a large number of rough endoplasmic reticulum in the fibroblasts cytoplasm.In the meluoling+dexamethasone group,there is a large number of mitochondria in vascular endothelial cells,there is no edema in the mitochondrial,there is rich rough endoplasmic reticulum and ribosomes,there is no degranulation phenomenon,the Golgi complexes were very advanced,there is a large number of ribosomes in the fibroblast,as well as the rough endoplasmic reticulum.Conclusions:Meluoling and dexamethasone can promote the survival rate of the flap,the NOS,MDA and SOD determination,the flap survival and MVD determination have significant differences.Meluoling and joint use of dexamethasone can play synergies,greatly increased the survival rate of flap.Meluoling promotion flap survival,the mechanism may be related to expansion of the blood vessels,the promotion of blood circulation,the adjustment of immune function,the inhibition of thromboxane formation effects.Dexamethasone promotion flap survival,the mechanism may related to the early reduction of neutrophil in ischemic tissue infiltration,lessen the aggregation and the inhibition of toxic substances such as oxygen free radicals release.The reduction of neutrophils in the ischemic tissue injury may be relevant.
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