Department of Plastic Surgery, University of Health Sciences, Bagcılar Training and Research Hospital, Istanbul, Turkey.
Department of Plastic Surgery, Ege University Faculty of Medicine, Izmir, Turkey.
J Surg Res. 2021 May;261:85-94. doi: 10.1016/j.jss.2020.12.025. Epub 2021 Jan 7.
The use of perforator propeller flaps in lower limb reconstruction has increased recently. Many pharmacological agents are used to increase flap viability. Botulinum toxin has been used in various types of flaps in the literature. However, there is no study regarding the use of botulinum toxin in the lower limb propeller flaps. This study investigates the effect of botulinum toxin administration on flap survival for lower limb propeller flap in rats.
The study included 20 male Wistar albino rats, divided into two groups with a flap rotation of 90° in group 1 and 180° in group 2. In both groups, botulinum toxin was administered to the right thigh and a physiological saline solution was applied to the left thigh. Five days later, flaps were elevated over the posterior aspect of the right and left thighs and inset after 90° and 180° rotation was performed. Histopathological, immunohistochemical, and necrosis area analyses were performed.
Necrosis area, edema, polymorphonuclear leukocyte infiltration, and necrosis were found to be higher on the left side of the groups, whereas epidermal thickness, collagen density, vascularization, and hair root density were found to be higher on the right side of the groups. No significant difference was found between the right posterior thighs in either group on any parameter other than vascularization. Histopathologically and immunochemically statistically significant differences were found between the two groups.
The present study found that botulinum toxin increases flap viability in lower limb perforator-based propeller flaps.
最近，在下肢重建中使用穿支螺旋桨皮瓣的情况有所增加。许多药理制剂被用于提高皮瓣的存活率。肉毒毒素已在文献中用于各种类型的皮瓣。然而，关于肉毒毒素在下肢螺旋桨皮瓣中的应用尚无研究。本研究旨在探讨肉毒毒素给药对大鼠下肢螺旋桨皮瓣皮瓣存活的影响。
本研究纳入了 20 只雄性 Wistar 白化大鼠，分为两组，每组皮瓣旋转 90°（第 1 组）和 180°（第 2 组）。两组均在右侧大腿给予肉毒毒素，左侧大腿给予生理盐水。5 天后，在右侧和左侧大腿的后外侧抬高皮瓣，并在完成 90°和 180°旋转后进行皮瓣植入。进行组织病理学、免疫组织化学和坏死面积分析。
左侧各组的坏死面积、水肿、多形核白细胞浸润和坏死程度较高，而右侧各组的表皮厚度、胶原密度、血管化和毛囊密度较高。除血管化外，两组右侧后大腿在任何参数上均无显著差异。组织病理学和免疫组织化学检查发现两组间存在统计学显著差异。
本研究发现，肉毒毒素可增加下肢穿支螺旋桨皮瓣的皮瓣存活率。
