Department of Plastic and Reconstructive Surgery, National Defense Medical College, Saitama, Japan.
J Surg Res. 2011 Sep;170(1):e189-96. doi: 10.1016/j.jss.2011.05.051. Epub 2011 Jun 23.
Skin flap necrosis is a problem encountered postoperatively. The purpose of this study was to evaluate the effects of platelet-rich plasma containing fragmin/protamine microparticles (PRP&F/P MPs) on viability in a rat dorsal paired pedicle skin (DPPS) flap.
Two symmetrical adjoining rectangular flaps (8 × 2 cm each) were drawn on the rat dorsum. Two days after PRP&F/P MPs-, PRP-, F/P MPs-, and saline (control)-injections (n = 8 each), flaps were elevated as a random pattern flap without the lateral thoracic, posterior intercostal, and deep circumflex iliac vessels. The flaps were immediately sutured back and the flap survival area was measured 7 d after flap elevation.
The flap survival rate in PRP&F/P MPs-injected groups (73.1% ± 4.2%) was significantly higher than those in PRP (64.9% ± 4.0%), F/P MPs (59.4 ± 4.5%), and control (61.2% ± 4.2%) groups. Histologic observation of the flaps showed survived thick granulation tissue and neovascularization in PRP&F/P MPs-injected groups.
When PRP&F/P MPs are administered 2 d before the flap elevation, the improved flap survivals are observed. The pre-injection of PRP&F/P MPs may thus represent a promising treatment to prevent skin flap necrosis in reconstructive surgery.
皮瓣坏死是术后遇到的一个问题。本研究旨在评估富含血小板的纤维蛋白/鱼精蛋白微颗粒（PRP&F/P MPs）对大鼠背侧对蒂皮瓣（DPPS）皮瓣活力的影响。
在大鼠背部画出两个对称的相邻矩形皮瓣（每个 8×2cm）。PRP&F/P MPs、PRP、F/P MPs 和生理盐水（对照）注射后 2 天（每组 n = 8），将皮瓣作为一种随机模式皮瓣抬起，不包括胸外侧、后肋间和旋髂深血管。皮瓣立即缝合回原处，并在皮瓣抬高后 7 天测量皮瓣存活面积。
PRP&F/P MPs 注射组（73.1%±4.2%）的皮瓣存活率明显高于 PRP（64.9%±4.0%）、F/P MPs（59.4%±4.5%）和对照组（61.2%±4.2%）。皮瓣的组织学观察显示，PRP&F/P MPs 注射组存活的厚肉芽组织和新生血管。
在皮瓣抬高前 2 天给予 PRP&F/P MPs 时，观察到皮瓣存活率提高。因此，PRP&F/P MPs 的预注射可能是预防重建手术中皮瓣坏死的一种有前途的治疗方法。
