Luo Shan, You Xiao-Bo, Liu Quan
Department of Plastic Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2020 Nov;51(6):803-808. doi: 10.12182/20201160204.
To investigate the effects of atorvastatin calcium (ATR) on the survival of ultra-long dorsal random skin flaps in rats.
Thirty SD rats were divided into five groups ( =6) according to the random number table: normal saline control group (CON group), ATR 10 mg/kg group (P10 group), ATR 20 mg/kg group (P20 group), ATR 30 mg/kg group (P30 group), and ATR 40 mg/kg group (P40 group). After pretreatment with ATR or 0.9% saline for 3 days, an ultra-long dorsal random skin flaps with size of 8 cm×2 cm was made on the back of each rat and replanted in situ. After the operation, the ATR or saline treatment lasted for 3 d. Seven days after operation, the appearance of skin flaps was observed with naked eyes, the survival rate of skin flaps was calculated. The pathological changes in the surviving areas of skin flaps were observed by HE staining, the number of microvessels in skin flaps was observed by immunohistochemistry staining, the mRNA expressions of vascular endothelial growth factor ( ) and basic fibroblast growth factor ( ) were tested by quantitative real-time PCR, and the contents of superoxide dismutase, nitrogen monoxide and malonaldehyde were tested by enzyme linked immunosorbent assays (ELISA).
On the 7 day after operation, the skin flap of the CON group showed a large area of necrosis, and the necrotic part formed crusts. Crusts were hard and inelastic, and a large amount of tissue fluid exudated. The fascial layer showed dark purple. No exudation of tissue fluid was observed in the flaps of P10, P20, P30 and P40 groups. The scab shell fell off naturally and the fur grew normally. HE staining of CON group showed that a large number of inflammatory cell infiltration, epidermal loss and necrosis in skin flaps, but the pathological changes in skin flaps were significantly improved after treatment with ATR. Compared with the CON group, the survival rate of skin flaps, the number of microvessels in skin flaps and the levels of mRNA, mRNA, SOD, NO in skin flaps also increased with the dose of ATR, which reached a peak at 30 mg/kg ATR ( <0.05). However, the level of MDA in skin flaps decreased with the dose of ATR, which reached the lowest at 30 mg/kg ATR ( <0.05).
ATR can enhance the survival of ultra-long dorsal random skin flaps in rats, which may be related to promoting microangiogenesis and inhibiting inflammatory and oxidative stress.
探讨阿托伐他汀钙（ATR）对大鼠超长背部随意皮瓣存活的影响。
将30只SD大鼠按随机数字表分为5组（每组n = 6）：生理盐水对照组（CON组）、ATR 10 mg/kg组（P10组）、ATR 20 mg/kg组（P20组）、ATR 30 mg/kg组（P30组）、ATR 40 mg/kg组（P40组）。用ATR或0.9%生理盐水预处理3天后，在每只大鼠背部制作大小为8 cm×2 cm的超长背部随意皮瓣并原位回植。术后，ATR或生理盐水处理持续3天。术后7天，肉眼观察皮瓣外观，计算皮瓣存活率。通过HE染色观察皮瓣存活区的病理变化，通过免疫组织化学染色观察皮瓣微血管数量，通过定量实时PCR检测血管内皮生长因子（VEGF）和成纤维细胞生长因子（bFGF）的mRNA表达，通过酶联免疫吸附测定（ELISA）检测超氧化物歧化酶、一氧化氮和丙二醛的含量。
术后第7天，CON组皮瓣出现大面积坏死，坏死部位形成痂皮。痂皮坚硬无弹性，有大量组织液渗出。筋膜层呈暗紫色。P10、P20、P30和P40组皮瓣未见组织液渗出。痂壳自然脱落，毛发正常生长。CON组HE染色显示皮瓣有大量炎性细胞浸润、表皮缺失和坏死，但ATR处理后皮瓣病理变化明显改善。与CON组相比，皮瓣存活率、皮瓣微血管数量以及皮瓣中VEGF mRNA、bFGF mRNA、SOD、NO水平也随ATR剂量增加而升高，在ATR 30 mg/kg时达到峰值（P < 0.05）。然而，皮瓣中MDA水平随ATR剂量降低，在ATR 30 mg/kg时达到最低（P < 0.05）。
ATR可提高大鼠超长背部随意皮瓣的存活率，这可能与促进微血管生成、抑制炎症和氧化应激有关。
