Effectiveness of Different Surgical Flap Delay Methods and Their Systemic Toxicities.


Journal

The Journal of craniofacial surgery
ISSN: 1536-3732
Titre abrégé: J Craniofac Surg
Pays: United States
ID NLM: 9010410

Informations de publication

Date de publication:
Historique:
pubmed: 20 1 2021
medline: 31 7 2021
entrez: 19 1 2021
Statut: ppublish

Résumé

The surgical flap delaying has been shown to be effective in preventing partial flap loss or in preparing larger flaps. However, there is no gold standard flap delay method in the literature. In this study, the authors aimed to compare 3 types of surgical delay methods to determine which model would increase more flap survival. The authors also investigated the effect of delay methods on circulating mononuclear leukocytes as a parameter of DNA damage. Twenty-four Sprague-Dawley male rats were divided into 4 groups. All subjects had a 10 × 3 cm modified McFarlane flap. Surface area measurements, biopsies, and blood samples were taken on the day of sacrification; 7th day for the control group and 14th day for delay groups. Between incisional surgery delay groups, a significant difference was found in necrosis and apoptosis in the bipedicled group, and only necrosis in the tripedicled group compared to the control. In terms of DNA damage, it was found higher in all experimental groups than in the control group. Both incisional surgical delay procedures' results were meaningfully effective when only incisions were made without the elevation of flaps. In conclusion, bipedicled incisional surgical delay seems to be the most effective method in McFarlane experimental flap model whereas two-staged surgeries may increase the risk of systemic toxicity.

Identifiants

pubmed: 33464774
doi: 10.1097/SCS.0000000000007444
pii: 00001665-900000000-92921
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1946-1950

Informations de copyright

Copyright © 2021 by Mutaz B. Habal, MD.

Déclaration de conflit d'intérêts

The authors report no conflicts of interest.

Références

Mathes SJ, Levine J. Thorne CH, Beasley RW, Aston SJ, Bartlett SP, Gurtner GC, Spear SL. Muscle flaps and their blood supply. Grabb & Smith's Plastic Surgery Sixth ed.Philadelphia, USA: Lippincott Williams & Wilkins; 2007. 42–52.
Bakamjian VY. Total reconstruction of pharynx with medially based deltopectoral skin flap. N Y State J Med 1968; 68:2771–2778.
Ghali S, Butler PE, Tepper OM, et al. Vascular delay revisited. Plast Reconstr Surg 2007; 119:1735–1744.
McFarlane RM, Deyoung G, Henry RA. The design of a pedicle flap in the rat to study necrosis and its prevention. Plast Reconstr Surg 1965; 35:177–182.
Camargo CP, Margarido NF, Guandelini E, et al. Description of a new experimental model skin flap for studying skin viability in rats. Acta Cir Bras 2014; 29:166–170.
Yildiz K, Karsidag S, Akcal A, et al. Comparison of the flap survival with ischemic preconditioning on different pedicles under varied ischemic intervals in a rat bilateral pedicled flap model. Microsurgery 2014; 34:129–135.
Yesiloglu N, Yildiz K, Cem Akpinar A, et al. Histogram planimetry method for the measurement of irregular wounds. Wounds 2016; 28:328–333.
Ormerod MG. Measurement of apoptotic cells by flow cytometry (tunnel assay). Methods Mol Med 2001; 39:665–668.
Henery S, George T, Hall B, et al. Quantitative image based apoptotic index measurement using multispectral imaging flow cytometry: a comparison with standard photometric methods. Apoptosis 2008; 13:1054–1063.
Singh NP, McCoy MT, Tice RR, et al. A simple technique for quantitation of low levels of DNA damage in individual cells. Exp Cell Res 1988; 175:184–191.
Dur A, Kocaman O, Koçyiğit A, et al. Oxidative status and lymphocyte DNA damage in patients with acute pancreatitis and its relationship with severity of acute pancreatitis. Turk J Gastroenterol 2016; 27:68–72.
Aktepe N, Kocyigit A, Yukselten Y, et al. Increased DNA damage and oxidative stress among silver jewelry workers. Biol Trace Elem Res 2015; 164:185–191.
Zheng HP, Lin J, Xu YQ, et al. Development History of Flap. Atlas of Perforator Flap and Wound Healing: Microsurgical Reconstruction and Cases. 2018; Springer, Singapore: Springer, 3–10.
Hamilton K, Wolfswinkel EM, Weathers WM, et al. The delay phenomenon: a compilation of knowledge across specialties. Craniomaxillofac Trauma Reconstr 2014; 7:112–118.
Acartürk TO, Dinçyürek H, Dağlioğlu K. Delay by staged elevation of flaps and importance of inclusion of the perforator artery. J Hand Microsurg 2015; 7:1–5.
Chiu-Collins LL, Epstein JS, Chu EA. Kountakis SE. Delay of flap. Encyclopedia of Otolaryngology, Head and Neck Surgery. Berlin, Heidelberg: Springer; 2013. 664–669.
Görgülü Tahsin. Selection of appropriate pedicle for dorsal skin flap studies on rats. Med Bull Şişli Etfal Hosp 2016; 50:93–96.
Unverdi OF, Coruh A. Effects of microneedle length and duration of preconditioning on random pattern skin flaps in rats. J Plast Reconstr Aesthet Surg 2020; 73:1758–1767.
Gersch RP, Fourman MS, Dracea C, et al. The delay phenomenon: is one surgical delay technique superior? Plast Reconstr Surg Glob Open 2017; 5:e1519.
Hurn IL, Fisher JC, Arganese T, et al. Standardization of the dorsal rat flap model. Ann Plast Surg 1983; 11:210–213.
Holzbach T, Neshkova I, Vlaskou D, et al. Searching for the right timing of surgical delay: angiogenesis, vascular endothelial growth factor and perfusion changes in a skin-flap model. J Plast Reconstr Aesthet Surg 2009; 62:1534–1542.
Morris SF, Yang D. Effect of vascular delay on viability, vasculature, and perfusion of muscle flaps in the rabbit. Plast Reconstr Surg 1999; 104:1041–1047.
Morris SF, Taylor GI. The time sequence of the delay phenomenon: when is a surgical delay effective? An experimental study. Plast Reconstr Surg 1995; 95:526–533.
Odland RM, Kim P, Nadler D, et al. Nonsurgical delay of skin flaps: effect of a suture delay technique on blood flow and survival. Laryngoscope 1995; 105 (5 Pt 1):523–528.
Kelly CP, Gupta A, Keskin M, et al. A new design of a dorsal flap in the rat to study skin necrosis and its prevention. J Plast Reconstr Aesthet Surg 2010; 63:1553–1556.
Tatlidede S, McCormack MC, Eberlin KR, et al. A novel murine island skin flap for ischemic preconditioning. J Surg Res 2009; 154:112–117.
Callegari PR, Taylor GI, Caddy CM, et al. An anatomic review of the delay phenomenon: I. Experimental studies. Plast Reconstr Surg 1992; 89:397–418.
Aydin OE, Algan S, Tan O, et al. A novel method for flap delay vacuum assisted flap delay: an experimental study in rabbits. J Plast Surg Hand Surg 2019; 53:208–215.
Jiang Z, Li X, Chen M, et al. Effect of endogenous vascular endothelial growth factor on flap surgical delay in a rat flap model. Plast Reconstr Surg 2019; 143:126–135.
Karacaoglu E, Yuksel F, Turan SO, et al. Chemical delay: an alternative to surgical delay experimental study. Ann Plast Surg 2002; 49:73–80.
Can A, Temel M, Dokuyucu R, et al. The effect of coenzyme Q10 (Ubiquinone) on random pattern skin flap survival in rat model. Ann Plast Surg 2016; 77:e9–e14.

Auteurs

Kemalettin Yildiz (K)

Department of Plastic Reconstructive and Aesthetic Surgery, Bezmialem Vakif University.

Semih Lutfi Mirapoglu (SL)

Department of Pediatric Surgery, Umraniye Research and Training Hospital, Istanbul, Turkey.

Ulkan Kilic (U)

University of Health Sciences, Department of Medical Biology, Istanbul, Turkey.

Ethem Guneren (E)

Department of Plastic Reconstructive and Aesthetic Surgery, Bezmialem Vakif University.

Abdurrahim Kocyigit (A)

Department of Biochemistry, Bezmialem Vakif University, Istanbul, Turkey.

Ahmet Kirazoglu (A)

Department of Plastic Reconstructive and Aesthetic Surgery, Bezmialem Vakif University.

Haci Omer Sagir (HO)

Department of Pediatric Surgery, Beykent University Faculty of Medicine.

Nebil Yesiloglu (N)

Department of Pediatric Surgery, Beykent University Faculty of Medicine.

Halil Ibrahim Canter (HI)

Department of Plastic, Reconstructive and Aesthetic Surgery, Anadolu Medical Center, Cumhuriyet Mahallesi, 2255 Sokak, No:3, Gebze Kocaeli.

Ali Cay (A)

Department of Pediatric Surgery, Private Beykent Hospital, Istanbul, Turkey.

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