Experimental Study On The Prevention Of Adhesion Of The DIEP With Sodium Hyaluronate

Objective:To observe Influence of the prevention of adhesion of the DIEP with sodium hyaluronate and to explore the mechanism of the medcine.Methods:Selected 14 of 1-1.5 years old healthy Bama closed group II male minipigs,purchased from experimental animal center of Zhejiang University of traditional Chinese medicine,in the hind limbs of establishment about the size of 5*4cm a margin of model underwent bilateral DIEP pedicled flaps to repair a hind leg wound,a total of 28 cases of flap,according to the operation sequence numbers for 1-28,and dual 1-28,as the experimental group,the singular as the control group.Sumianxin Ⅱ 0.32 ml/kg,ketamine 15mg/kg intramuscular injection,anesthesia endotracheal intubation,anesthesia ventilator connected with pure oxygen drive during the administration to maintain anesthesia.The wound,design the hind limbs of skin and soft tissue defect exposed tendons,partial resection of the aponeurosis.The wound size is about 5*4cm,bilateral DIEP pedicled flap wound repair hind in experimental group,sodium hyaluronate(drug name:Sofastin)combined with salvianolate evenly on the tendon and tendon tissues.The operation was performed by the same group of surgeons.After operation were given conventional anti-inflammatory,analgesic,hibernation therapy,the method of suspending cloth towel stomachers raised in cage,room temperature control at about 25℃,giving the infrared radiation.The postoperative 14d flap were observed and the incidence of vascular crisis and survival rate of excellent,covers a total area of the sulfuric acid paper described the survival,by using the method of weight generation surface area obtained by weighing sulfuric acid paper Calculate the flap survival rate.At 14 days after the operation,28d,84 take flap center to 0.2 cm x 0.4 cm in size and full thickness flap,block was placed in 10%neutral formalin fixed 24 hours will be organized,embedded in paraffin,section,hematoxylin and eosin(he)staining,light microscope observation into fiber cells and inflammatory cells expression.Results:1 DIEP flap vascular crisis occurred and the excellent and good rate:control group vascular crisis occurred in 3 cases,sodium hyaluronate combined with Salvia miltiorrhiza depside salt from group 1 cases,the excellent and good rate of the flap in the experimental group were 83.5%,52.4%in the control group;the flap in the experimental group was quality is obviously superior to the control group(P<0.05).2 DIEP flap survival rate:the experimental group was significantly higher than that of the control group(P<0.01).3 The pig tendon activity and general function of the activity level:14th in the experimental group and the control group tendon activities and general functional activity had no significant difference(P<0.05).On the 28th,the experimental group and the control group tendon activities and general functional activities have significant difference(P<0.05).The 84,the experimental group and the control group tendon activities and general functional activities have significant difference(P<0.05).4 After the operation,the gross observation and light microscope:14d,28d,84d,the degree of adhesion of the experimental group were better than that of the control group,there was a significant difference(P<0.05).5 Postoperative 28d immunohistochemical indicators of changes:the experimental group CD45,TGF-β1 were lower than the control group(P<0.05),each time point two two comparison were statistically significant(P<0.05).Conclusion:The adhesion of tendon and skin flap is a major cause of postoperative dysfunction and two surgery,sodium hyaluronate combined with salvianolate can reduce the inflammatory reaction and hyperplasia and improve the survival rate of skin flap,flap to prevent postoperative adhesion,improve skin flap survival rate to a certain extent.