| objective: From the research of combined with Dexamethasone and Hydrogen-rich saline on rat’s random skin flap, observe that the effect of the survival area of random skin flap and histological morphology, and confirm that the effects on preventing the necrosis of flap. In order to increase the rate of the transplantation of skin flap and explore an effective new way. Through the quantificational measurement of the concentration of MDA and SOD on flap. Preliminarily discuss the mechanism of their roles to protect flap from necrosis, and providing reliable evidence for clinical application. Methods: Laboratory animals: 68 healthy SD rats(provide by Luzhou medical college laboratory animal center, weighing 260±15g), male or female. The animals were randomly divided into 4 groups. 17 rats were used in every group.Group A was Hydrogen-rich saline group: Intraperitoneal injection of Hydrogen-rich saline 5ml/(kg·d);Group B was Hydrogen-rich saline+ Dexamethasone group:5mg/(kg · d) of Dexamethasone and 5ml/(kg·d) of Hydrogen-rich saline was injected in the same way; Group C was Dexamethasone group: Intraperitoneal injection of Dexamethasone 5mg/(kg·d); Group D was the control group: Intraperitoneal injection of saline 5ml/(kg·d). Postoperative observe on skin flap survival everyday. 7th day after operation kill all rats and remove the center of square flap tissue. Made flap from tissue homogenates then detection of SOD、MDA contents. Count the area of flap in each group. Taking the flap of near, middle and far do routine HE stain. Watch the number of granulation tissue, the number of inflammatory cells and so on. 7d after the operation, observe skin flap. In the experimental groups around the proximal part of the flap colors is close to normal skin. We can see good elasticity, hair growth. Middle area color darken gradually from near to far. No crust to form on the surface, no hair growth. Far-field flap′color is black and covered with crust, inelastic. The region of flap of proximal and middle of control group survival less than experimental groups, far more necrosis area larger than experimental groups. Survival rates of flap: DXM+HRS>HRS>DXM> control group. SOD、MDA in each group was 63.5+2.05、3.3+0.18; 56.0+1.03、4.3+0.15; 54.2+1.29、5.3+0.12; 42.4+1.97、8.3+0.15, p<0.05. HE section was observed. In the control group stratum has shrunk, and subcutaneous tissue has separated the table, tissue edema, and has generated little hairs. In the dexamethasone group, there was light keratosis, integrity, mild subcutaneous edema, fibrosis and granulation tissue. In the Hydrogen-rich saline group, there was light keratosis, fibrosis, integrity and granulation tissue, no subcutaneous edema. In the DXM+HRS group, flap were integrity, fibrosis and granulation tissue, no keratosis, no subcutaneous edema. In the middle flap, the number of capillaries were DXM+HRS >HRS>DXM>control group. Cut the middle flap tissue and observe microvascular number under light microscope.We can see DXM+HRS(7.4±0.35)﹥HRS(5.7±0.59)﹥DXM(5.3±0.46)﹥control group(3.2±0.53).There were no different between HRS and DXM(P﹥0.05).The result of 4 groups shows different(P﹤0.05)Results: DXM and HRS can promote survival of random flap. In the flap, the content of the MDA、SOD and the area of flap have significant differences. DXM+HRS combined with synergy. Random skin flap survival rate was more than any single application. Mechanisms of HRS for promoting skin flap survival may be associated with anti-inflammatory, selective removal of free radical and anti-apoptotic role and improve the function of local skin flap and other relevant. Dexamethasone for random skin flap survival may be associated with early playing reducing neutrophil adhesion, invasion, accumulation and reducing release of toxic substances, reducing the polymorphonuclear cells and ischemic tissue damage from free radical-related。... |
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