The Effect of Topical Atorvastatin on Viability of Random Pattern Skin Flaps, Experimental Study

Öz

Augmentation of viability of random pattern flaps has long been an issue in plastic surgery. Up to date no agents were clinically introduced. Atorvastatins are used clinically for lipid lowering. They are also effective on flap survival with their angiogenic, anti-inflammatory, antioxidant effects with systeic administration. In this study, Atorvastatin is used topically for flap survival alleviation in Mc Farlane flap in rats. Wibstar albino type 20 male rats weighing about 180-230 grams were classified as experiment and control group. Results were evaluated by flap necrosis ratios, lymphocyte cells, neutrophile cells, capillary and granulation tissue density on the 7th postoperative day.. Flap necrosis areas were evaluated with Sasaki's paratemplate method. Tissue biopsies of 1x1 cm at the transition zone between necrotic and healthy tissue, were embedded in parafin blocks after fixation in 10% formalin. Biopsies were sliced by 4 micrometer thickness with a microtome. Cross sections were painted with hematoxylene eosin and evaluated with a light microscope. Whitneyy U test was performed for clinical and histopathological evaluation of groups (p<0,05). Flap viability was alleviated. Average necrosis ratios on flaps were 32.1% in the control group and 14.17% in experimental group. Capillary tissue and neutrophile cell density were found to be higher in atorvastatin group. . Granulation tissue and lymphocyte cell density were not found significantly higher.. Atorvastatins, when applied topically, are effective on flap survival. Further studies should be carried out for human clinical use.

Anahtar Kelimeler

• Flap
• survival
• atorvastatin
• topically
• angiogenesis

Topikal Atorvastatinin Random Paternli Cilt Fleplerinin Yaşayabilirliğine Etkisi ,Deneysel Çalışma

Öz

Random fleplerin yaşayabilirliğinin arttırılması plastik cerrahide,süregelen araştırmalara konu olmuştur. Bir çok ajan denenmiş ancak çoğu klinik kullanıma girememiştir. Atorvastatinler lipid düşürücü olarak kullanılmaktadır. Ayrıca , sistemik uygulama ile flep yaşayabilirliğini , arttırdıkları deneysel olarak gösterilmiştir. Bu çalışmada atorvastatinin , topikal uygulama ile flep yaşayabilirliğine etkisi araştırılmıştır. 180-230 gram ağırlığında wibstor albino tipi , 20 erkek rat kontrol ve deney grubu olarak ayrılmıştır. Her bir grupta , Mc Farlane flebi eleve edilmiş , deney grubunda flep üzerine, hazırlanan atorvastatin krem uygulanırken;kontrol grubu herhangi bir tedavi almamıştır. İşlemden 7 gün sonra flep sağlıklı ve nekrotik doku geçiş zonundan 4 mm’ lik kesitler halinde doku örnekleri alınarak ,hematoksilen eozin ile boyanmış ve ışık mikroskobu altında lenfosit hücre yoğunluğu, notrofil hücre yoğunluğu , kapiller dansite ve granulasyon dokusu dansitesi açısından incelenmiştir. Fleplerdeki nekroz alanları sasaki kağıdı metodu ile işaretlenmiş, işaretleme AUTOCAT 2012 programına aktarılarak fleplerdeki nekroz oranları bulunmuştur. Histolojik parametlerin ve fleplerdeki nekroz oranlarının karşılaştırılması için Mann Whitney U testi kullanılmıştır (p<0,05) Çalışmaya göre deney grubunda notrofil hücre yoğunluğu ve kapiller dansite artmış, granulasyon dokusu dansitesi ve lenfosit hücre yoğunluğu ise değişmemiştir. Flep nekroz oranının atorvastatin uygulanan grupta azaldığı gösterilmiştir. Flep nekroz oranı kontrol grubunda 32,1% iken deney grubunda 14,17% olarak bulunmuştur .Ek çalışmalara ihtiyaç olmakla birlikte , atorvastatin topikal olarak kullanım ile flep yaşayabilirliğini arttırmaktadır.

Anahtar Kelimeler

• flep
• yaşayabilirlik
• atorvastatin
• topikal
• anjiyogenez

Kaynakça

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