| Objective: This study is based on the experimental of Rabbit Skin Flap combined with acidic Fibroblast Gowth Factor(aFGF)and Low Molecular Weight Heparin(LMWH),to observe the random flap survival,flap pathological changes,to explore aFGF and LMWH on whether to reduce random flap necrosis.Methods: 12 rabbits were randomly divided into 4 groups(n = 3-4),aged 2500 g months and 500 g months old,were randomly divided into two groups(n = 3).Group A(control group),B group(LMWH group),C group(aFGF group),D group(a FGF+ LMWH group).The day before the operation with 10%sodium sulfide on operation area of skin,with 1% pentobarbital sodium 3ml/kg by ear vein injection on experimental rabbit anesthesia,routine disinfection,towel,in rabbit abdominal midline axis of bilateral abdominal back each design of 3 side length 2cm,width 6cm of the random skin flap incision flap edge off flap after suture in situ formation of random flap.Immediately after the operation,4 flaps were selected at each location in the middle and distal part of the random flap(3-6cm).Group A sterile saline 0.4ml/ flap,group B of low molecular weight heparin injection(1ml:50iu)0.4ml/flap,group C of acidic Fibroblast Growth Factor(5000IU/ml)0.4ml/ flap,D group,Low molecular Weight Heparin Injection(1ml:50iu)0.4ml/ flap+ acidic Fibroblast Growth Factor(5000IU/ml)0.4ml/ flap flap injection.Flap changes were observed after surgery,postoperative fifth days after surgery,postoperative seventh days and thirtieth days after surgery in each group were randomly sacrificed a rabbit,and with a transparent grid paper depicted and calculated the survival area of the flap,flap in the distal(3-6cm)specimens from the specimens from the middle score 2,a 10% Formaldehyde Solution fixed,routine HE staining and immunohistochemical determination of VEGF,microvessel density determination;one for determination of MDA content.SPSS16.0 software was used for statistical analysis.Results:(1)The general observation: after 3days flap from the naked eye view,each section has much congestion,no significant difference between the groups.After the 5days,each flap of proximal small amount of hair growth,good elasticity,color pink,the color gradually increased from near to far,no hair growth,distal flap has a different degree of blackening,poor flexibility,the three experimental group thanin the control group the congestion of light.After 7days,the boundary flap survival area and the necrosis are obviously,flap edge area and the color black crust coverage,distal flap color black hard surface crust.After 30 days,there was a lot of hair growth in the flap area,and the necrosis of the distal necrosis area became thin and hard to close to the membrane.(2)The survival rate of the flap;the total survival rate of the control group(50.33±2.77)< The LMWH group(52.83 ± 2.18)< aFGF group(54.50 ±2.53)< aFGF+LMWH group(61.17±4.23),comparison between the 22 groups showed that: aFGF group and LMWH+aFGF group(P > 0.05)there was no significant difference between other groups,P values were less than 0.05,there are significant differences(3)Study results: after 5D HE staining and 7d HE staining in four groups had distal skin flap necrosis,inflammatory infiltration,subcutaneous edema,granulation tissue growth,control group necrosis larger,neutrophil infiltration more.In group LMWH and group aFGF,the edema of subcutaneous tissue was lighter,and the stratum corneum was lighter than that in LMWH+aFGF group.After 30 d,each group of neutrophil infiltration phenomenon were reduced,the experimental group there were neovascularization,cells were hyperplasia,LMWH+a FGF group was more obvious,the control group only a small amount of capillary formation,cell proliferation is not obvious.(4)The total microvessel count: the control group(3.39 ± 0.92)<LMWH group(3.61±0.98)<aFGF group(5.56 ±0.86)<LMWH+a FGF group(6.67±0.90),between the 22 groups compared with LMWH group and aFGF group(P > 0.05)there was no significant difference between the other groups.Between(P < 0.05)difference.(5)Immunohistochemistry VEGF: the number of positive cells in the skin flap,the control group(4.89 ± 1.49)<LMWH group(5.94± 1.26)<aFGF group(8.44±1.33)<LMWH+aFGF group(8.44 ± 1.65)branch,the results of the comparison between the groups: the difference between the groups was significant,P < 0.05.(6)The determination of MDA content: the control group(80.78 ± 2.90)> LMWH group(77.67± 4.17)> aFGF group(70.89 ± 4.38)> LMWH+a FGF group(57.50±5.00)The comparison between the22 groups showed a significant difference between the groups,P < 0.05.Conclusion: The immediate postoperative flap treated with a small dose of low molecular weight heparin and acidic fibroblast growth factor can reduce the rabbit free skin flap necrosis,increased vascular density,the survival of the flap survival rate,increasing the flap could result in the increasing of expression of VEGF in the flap,there are significant differences between the determination of skin tissue MDA and the rate of flap survival.The combination of low molecular weight heparin and acidic fibroblast growthfactor can promote the formation of blood vessels under the skin flap... |
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