Effect of adipose tissue-derived stromal vascular fraction on the viability of random-pattern skin flaps: an experimental study

Abstract

Aims: Random pattern skin flaps are still widely used in plastic surgery. However, necrosis in distal flap sections resulting from ischemia is a serious problem, increasing the cost of treatment and hospitalization. The aim of this study was to test the effects of adipose tissue derived stromal vascular fraction (SVF) on random pattern skin flaps in rats. Methods: In this experimental study conducted on Wistar rats, three groups were formed using the simple random sampling technique. Group 1 consisted of rats with a raised flap and a subcutaneous SVF injection. Group 2 comprised rats that underwent a flap operation with no additional treatment. Group 3 included rats with a raised flap and a subcutaneous saline injection. Tissue necrosis and level of survival area was detected with planimetric method and histopathologic examination was performed for detect of level of vascular density. On the 7th day post-operation, the viability assessment was calculated based on the ratio of the living flap area to the total flap area. Results: The mean viability rate in Group 1 was higher compared to other groups, while there was no significant difference between Group 2 and Group 3 (Group 1 = 79.2 ± 4.9 % vs. Group 2 = 41.0 ± 5.9 % vs. Group 3= 39.2 ± 2.7 %, p < 0.001). The mean vascular densities of the flaps were higher in Group 1 compared to the other groups, while it were similar between Group 2 and Group 3 (Group 1 = 29.8 ± 1.2 vs. Group 2 = 8.4 ± 4.6 vs. Group 3= 9.3 ± 1.8, p < 0.001). Conclusion: The use of fat tissue-derived SVF injections has been found to be advantageous in improving the survival of random pattern flaps, frequently utilized in plastic and reconstructive surgery.