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  • Küçük Resim
    Öğe
    Effects of some pharmacological agents on the survival of unipedicled venous flaps: An experimental study
    (Wiley-Blackwell, 2001) Aşkar, İbrahim; Saray, Aydın; Gürlek, Ali; Sevin, Kutlu; Sabuncuoğlu, Bizden Tavil
    Clinical and experimental studies have been conducted to improve the survival of venous flaps, As a result of these studies, although various survival mechanisms were raised, none obtained satisfactory information. Venous stasis, and the resultant venous thrombosis, is a factor that decreases the survival of venous flaps. In this study, we evaluated the effects of two antiinflammatory agents, etodolac and etofenamate, on the survival of unipedicled venous flaps. In this study, 35 male New Zealand white rabbits (3,500-4,000 g) (70 ears) were used. Perichondrocutaneous flaps, 3 x 4.5 cm in size, were designed and raised, keeping the central veins intact in the middle of venous flap. Central arteries and nerves were ligated and transected both proximally and distally, to prepare unipedicled venous flaps. A silicone sheet was placed between the cartilage tissue and flap, to prevent blood flow and revascularization beneath. The subjects were divided into seven groups, consisting of five rabbits (10 ears). In the negative control group (group 1), the single vascular pedicle of venous flaps, central veins were ligated and flaps sutured into their own place as the composite graft. In the positive control group (group 11), after venous flaps were prepared, normal saline, 0.2 mL, was given subcutaneously. In the first of five experimental groups (group III), unfractionated heparin (100 U/day) was given subcutaneously. In the second experimental group (group IV), etodolac (5 mg/kg/day) was given subcutaneously, In the third experimental group (group V), etophenamate (5 mg/kg/day) was given orally through a feeding tube. In the fourth experimental group (group VI), parnaparin (5 anti-Xa U/kg/day) was given subcutaneously. In the fifth experimental group (group VII), nadroparin (5 anti-Xa U/kg/day) was given subcutaneously, about 7 days postoperatively. At the eighth postoperative day, surviving areas of venous flaps were measured, and the results were evaluated by Kruskal-Wallis ANOVA and Mal Whitney U-test (P < 0.05). Biopsies were also taken from the flaps for histological evaluation of border of necrotic tissue, Surviving areas of unipedicled venous flaps were larger in experimental groups than those in negative and positive control group (P < 0.05). However, comparison of the experimental groups demonstrated no statistically significant dierence (P > 0.05). We concluded that all pharmacological agents used in the experimental groups succeeded in increasing the survival of unipedicled venous flaps. Survival of the unipedicled venous flap was higher in venous flaps than that of composite graft, clearly showing the importance of the venous pedicle.
  • [ X ]
    Öğe
    Etofenamat'ın random paternli sıçan dorsal deri flebi yaşayabilirliği üzerine etkisi
    (2000) Aşkar, İbrahim; Gürlek, Ali; Sabuncuoğlu, Bizden T.; Sevin, Kutlu
    Deri defektlerinin rekonstrüksiyonu için birçok deri flebi geliştirilmiştir. Distal flep nekrozu, özellikle uzun deri flepleri kaldırılırken, önemli bir problem olarak karşımıza çıkmaktadır. Bu nedenle, distal flep nekrozunu önlemek ve flep yaşayabilirliğini artırmak için birçok deneysel ve klinik çalışma yapılmıştır. Bu deneysel çalışmada, anti-inflamatuar ajan olan etofenamatın deri flebi yaşayabilirliği üzerindeki etkisi araştırıldı. Sprague-Dawley cinsi sıçanlarda, 3x10 cm boyutlarında pannikulus karnozus içeren kaudal tabanlı random paternli dorsal deri flebi kaldırılıp, yerine iade edildi. Kontrol grubuna herhangi bir farmakolojik ajan verilmezken, deney grubuna postoperatif dönemde yedi gün boyunca etofenamat 10 mg/kg/gün, im olarak verildi. Yedinci günde deri fleplerinin yaşayan alanları ölçüldü ve sonuçlar "Student's t-test" ile değerlendirildi. Yaşayabilen flep oranları etofenamat grubunda %83.27 ve kontrol grubunda %65.70 olarak bulundu. Etofenamatın flep yaşayabilirliğini, kontrol grubuna oranla, istatistiksel olarak anlamlı bir şekilde arttırdığı bulundu (p<0.05). Yedinci günde nekroz-canlı doku hattından biyopsi alındı ve histopatolojik değerlendirme yapıldı. Histopatolojik değerlendirmede, nekroz-canlı doku sınırında, her iki grupta da flep ile flep yatağı arasında damarlanmada artış görülürken, deney grubunda kontrol grubuna oranla daha az inflamatuar hücre infiltrasyonu izlendi.