Hydrogen And Dexamethasone Effect On Random Flap Survival In Rats

Background:In plastic surgery,orthopedic,cranial and maxillofacial surgery,For easy and flexible to use random flap,Is often used to repair tissue defects,But no clear known vessels in the free skin flap,Combined with skin Flap transplantation or transfer of ischemia-reperfusion injury caused part or the whole skin flap necrosis are the most common problems.In recent years,With the rapid development of modern medicine,Although skin flap transplantation survival rate significantly increased,But the skin flap necrosis leads to surgical failures is still common.Whether skin flap graft survival the key lies in whether it avoid ischemia-reperfusion injury.Studies have shown that,Skin flap necrosis associated with hypoxia,inflammatory reaction and free radical damage,before,Related experiments show Hydrogen can improve heart,brain,kidney and other organs of ischemia-reperfusion injury.The characteristics of hydrogen cheap,convenient and accessible,and non-toxic harmless,Make it as a new treatment method to increase the skin flap survival open up a simple and effective way.Dexamethasone belongs to glucocorticoids,Have anti-inflammatory,shock resistance,resistance to bacterial endotoxin,and strengthen the body stress ability,With membrane stability,prevent lysosome rupture,reduce the synthesis and release of inflammatory factors.inhibite platelet aggregation.In 1995,Dolan is the first to use dexamethasone in the treatment of ischemic skin flap,Results show that dexamethasone on ischemia-reperfusion flap has the very good protection effect;Cao Jing Min prove that dexamethasone can also be a very good protection of ischemia-reperfusion injury of the flap venous return,and the best dose is 5 mg/Kg.Dexamethasone can reduce white blood cells concentrate in local tissue,to protect the corresponding organization.Curative effect observation of hydrogen and dexamethasone on flap transplantation has relatively few research and application,This study with rats as experimental animals,To observe whether hydrogen and dexamethasone can improve the skin flap survival area and whether the two have synergy on flap survival.Purposes: The purpose of this experiment is to establish a typical animal model of random flap,With this model to study dexamethasone,hydrogen treatment both combined protective effect of random flap,Dexamethasone,combined with hydrogen to evaluate prospects.Method: In this experiment,SD rats as a model,First built back long random flap,At the end of pedicle width 1cm×6cm long.We compared untreated ? intraperitoneal injection of dexamethasone treatment ? by intraperitoneal injection of hydrogen-rich saline treatment,Both intraperitoneal injection flap perfusion and survival,Tissue sections was observed growth of granulation tissue flap,Changes in blood inflammatory factors and so on.Result: Flap substantially and HE staining,A group(Hydrogen-rich saline):Flap eye view of group C with approximate,Skin elasticity slightly better than group C,Open the flap visible granulation tissue thin layer of subcutaneous,Large amount of active bleeding,It shows a small amount of inflammatory exudate.B Group(Hydrogen-rich Saline+ Dexamethasone): Visible hair growth proximal flap,Good elasticity flap?pink,The middle of the middle area from near and far flap reddish gradually darken,Flap surface without hair growth no crust shell cover,Edge flap decreased elasticity,A small amount of visible crust shell cover;distal black,poor flexibility flap,surface crust shell coverage.Open the flap can see the granulation tissue grew well,More bleeding,No effusion of blood under the skin flap,Rich in blood vessels.C group(Dexamethasone): Good elasticity proximal flap,pink,poor hair growth;middle color gradually darkens,no hair growth and visible black crust shell cover,poor flexibility;Distal flap crust shell more,color black,poor flexibility.Open the flap can see a small amount of granulation tissue and a small amount of exudate.D group(NS): Flap heel can see a little hair growth,From near and far gradually darken in color from red to dark,and the middle section surface crust shell cover,poor skin elasticity,Open the flap can see less bleeding,vascular sparse leaking more.It was observed in each group see D group survived the worst,B composed of living was better than group A and group C.Four groups according to Hydrogen-rich saline ? Dexamethasone ? Hydrogen-rich saline +Dexamethasone?NS,SOD?MDA Contents were: 63.5±2.04?3.3±0.17;56.0±1.02?4.3±0.14;54.2±1.29?5.3±0.11;42.4±1.96?8.3±0.14;Tissue flap SOD?MDA values are compared,p<0.05,There are significant differences between the groups.Four groups according to Hydrogen-rich saline?Dexamethasone?Hydrogen-rich saline+Dexamethasone?NS,EPO Contents were: 145.3±5.68,132.8±6.37,182.8±14.45,129.42±6.83,Tissue flap EPO values are compared,comparison between groups,Hydrogen-rich saline and Dexamethasone,P > 0.05,no significant difference,Other groups for statistical analysis: P < 0.01,There are significant differences between the groups.Flap tissue Micro-vascular count: Hydrogen-rich saline + Dexamethasone(7.5±0.36)>Hydrogen-rich saline(5.8±0.60)>Dexamethasone(5.4±0.45)>NS(3.3±0.54).Statistical results of each group show P<0.01,There are significant differences between the groups.In conclusion: Hydrogen-rich saline and Dexamethasone intraperitoneal injection can improve skin flap survival in rats,Having a synergistic effect between the two,Specifically in Rat skin flap survival rate increase?reduce inflammation,this might be Hydrogen-rich saline and Dexamethasone can reduce inflammation?anti-oxidation effects.