CLINICAL AND ECHOGRAPHIC EVALUATION OF THE EFFECTS OF EPINEPHRINE AND PLATELET-RICH PLASMA SOLUTION ON MODIFIED MCFARLANE SKIN FLAP IN RATS
Aim: The aim of the study was to test the effects of the administration of the platelet-rich plasma solution in the same time with epinephrine in frequently used skin flap model in rats, and to notice the vascular response of the flap pedicles using ultrasound exploration. Material and methods: the experimental study took place at the Advanced Research Centre for Experimental Medicine (C.E.M.E.X), at the “Grigore T. Popa” University for Medicine and Pharmacy Iasi. We used 27 adults male Whistar rats, 6 of them were used as donor source for the PRP (platelet rich plasma) solution. The rest were split in 3 groups of study: on the first group we performed the modified McFarlane 8 x 3 cm, the second group received epinephrine 0.1 mg/kg intraperitoneally, and the third group received 1 mL solution of PRP subcutaneously, in the same points of the flap, alongside epinephrine. In the third postoperative day, a clinical assessment and photographic documentation was done. On the same day, the ultrasound exploration was done. Results: we calculated the percentage of skin necrosis, by calculating the areas of normal and necrotic skin, and comparing them. The highest rate of necrosis was observed in the second group (55.3 %) compared with the first group (48.5 %) and the group that received PRP (29.7 %). The second group also had the smallest pedicle’s sizes, corelating with the area of skin necrosis. The biggest pedicles were found in the third group. The epinephrine only group had a very important variation of the pedicle’s flow speed. Discussion: the ultrasonography is a machine and operator-dependent procedure, non-invasive and quick to perform, which brings valuable date regarding small perforators of the skin. In order to analyze such small perforator, like the pedicles of this modified skin flap, it is important to set the correct modes and to choose appropriate anatomical landmarks. Sometimes, it is difficult to measure the dimensions of the pedicles and their flow speed too. Clinical assessment of the flap was assessed in 5th postoperative day. Special digital software is helpful when we want to distinguish other colors apart from white and black, and to strictly delineate the normal skin from the necrotic one. Conclusions: our data do corelate with the literature, confirming the effect of the PRP on this type of rat skin flap, even though a small quantity of epinephrine was added.
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