| Objective:To investigate the effects of PRP(platelet-rich plasma),alprostadil and its combination on rabbit ischemic skin flap.To compare the effect of the two alone application on rabbit ischemic skin flap,and whether the combined application of the two is better than the single application.Methods:Select 40 rabbits as the test subjects,and use statistical methods to randomly divide them into 20 groups,2 rabbits in each group.Two flaps of the back of each experimental rabbit are designed to be symmetrical on the midline with a length-to-width ratio of 10.0 cm*2.5 cm,forming 4 rabbit dorsal ischemic skin flap models in each group.Each group was randomly divided into control flap and experimental flaps.The control flap was injected locally with the skin flap and 0.9%sodium chloride solution was injected into the ear vein;the treatment method of the experimental flaps:(1)experimental flap(1)(PRP group):PRP was injected locally in the skin flap,and the ear vein vein Instillation of 0.9%sodium chloride solution;(2)experimental flap(2)(alprostadil group):local injection of the same amount of 0.9%sodium chloride solution on the skin flap,intravenous drip of alprostadil(0.8 ml/kg*7d)into the ear vein;(3)experimental flap(3)(combined application group):skin flap local injection of PRP,intravenous drip of alprostadil(0.8 ml/kg*7d)into ear vein.On the 7th day after the operation,photographs and materials were taken under a uniform standard.After grossly observing the survival of the local skin flaps,measure the survival area of each flap to calculate the survival rate of the flaps;observe the structure level,inflammatory cell infiltration and microvessel caliber of each flap under the microscope after HE staining;detect CD34 expression by immunohistochemistry Circumstances,measurement of microvessel density;ELISA to detect VEGF content.Results:On the 7th day after operation,1.General observation:different degrees of ischemic necrosis occurred in both the control flap and the experimental flaps from far to near.After measurement and calculation,the results were as follows:(1)The average survival area of each flap:experimental flap(3)(18.2125±0.58756 cm~2)>experimental flap(1)(15.90±0.60914 cm~2)>experimental flap(2)(12.750±0.71174 cm~2)>control flap(9.23±0.58756cm~2),the difference are statistically significant(P<0.05);(2)Survival rate:experimental flap(3)(72.85±2.834%)>experimental flap(1)(63.60±2.437%)>experimental flap(2)(52.30±4.575%)>control flap(36.9±2.350%),;the difference are statistically significant(P<0.05). 2.Histological observation:(1)Observation under microscope after HE staining shows that all the experimental flaps have less edema and more new capillaries than the control flaps;the experimental flap(3)is compared with the control flap and the experimental flap(1).The structure and level of the flap(2)are more clear and distinct,with the most new capillaries,most of the lumens are enlarged,less neutrophils infiltration,and less tissue edema;the experimental flap(1)has a clearer tissue structure than the experimental flap(2),with more new capillaries,and neutrophils are less infiltrated,but the experimental flap(2)has a larger lumen diameter;(2)Microvessel density:experimental flap(3)(26.15±1.387strips/mm~2)>experimental flap(1)(22.90±1.553 strips/mm~2)>experimental flap(2)(19.85±1.182 strips/mm~2)>control flap(9.40±1.273 strips/mm~2);(3)Capillary diameter:experimental flap(2)(123.250±2.9957 um),experimental flap(3)(123.392±2.9361 um)>experiment flap(1)(110.084±2.3702 um)>control flap(100.647±1.5142 um),the difference are statistically significant(P<0.05).However,the experimental flap(2)and the experimental flap(3)are compared to analyze the microvessel caliber,and the significance level is>0.05,There is no significant difference between the two.(4)VEGF content:experimental flap(3)(496.930±25.206 ng/L)>experimental flap(1)(398.399±20.917 ng/L)>experimental flap(2)(336.625±30.562 ng/L)>control flap(308.205±17.194ng/L),the difference are statistically significant(P<0.05).Conclusion:Both platelet-rich plasma and alprostadil injection can improve rabbit ischemic skin flap avascular necrosis to varying degrees when used alone,increasing the survival rate of flaps,but the effect of PRP was better than that of alproteril,and the combined effect of the two is better than that of single use. |
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