Effect of Natural Hirudin on Random Pattern Skin Flap Survival in a Porcine Model

Abstract

Local administration of hirudin can significantly increase the surviving area in overdimensioned random pattern skin flaps, in a porcine model.

Experience with pharmacologic leeching with bivalirudin for adjunct treatment of venous congestion of head and neck reconstructive flaps

“…Ying‐Xin et al reported increased survival in compromised free flaps in rats after subdermal injections of both natural or recombinant hirudin compared to controls injected with saline (Ying‐Xin et al, ). Similarly, increased survival of surface area of compromised random pattern skin flaps after local subdermal injection of natural hirudin compared to controls have been reported in the porcine models (Guo‐Qian et al, ; Zhao et al, ). Furthermore, intravenous injection of recombinant hirudin in regional flaps in rabbits has been reported to increase surface area survival compared with injection of low molecular weight heparin or no injection (Duzgun et al, ).…”

“…Previous work reports the use of recombinant or natural hirudin in the treatment of venous congestion in animal models (Duzgun et al, ; Guo‐Qian et al, ; Ying‐Xin et al, ; Zhao et al, ). Ying‐Xin et al reported increased survival in compromised free flaps in rats after subdermal injections of both natural or recombinant hirudin compared to controls injected with saline (Ying‐Xin et al, ).…”

“…Bivalirudin is a direct inhibitor of thrombin (which activates both platelets and other clotting factors), thereby leading to an inhibition of the clotting cascade (Di Nisio et al, 2005). Additionally, local injection of natural or recombinant hirudin directly into congested flaps have revealed evidence of improved flap survival in rat (Ying-Xin, Guo-Qian, Jia-Quan, & Han, 2012), rabbit (Duzgun, Nisanci, & Unlu, 2014), and pig models (Guo-Qian, Gang, & Zhi-Yong, 2012;Zhao, Shi, Sun, Yin, & Yang, 2012). The extent to which recombinant hirudin, such as bivalirudin, may aid in relief of venous congestion in head and neck reconstructive flaps in patients has not previously been studied.…”

“…Previous work reports the use of recombinant or natural hirudin in the treatment of venous congestion in animal models (Duzgun et al, 2014;Guo-Qian et al, 2012;Ying-Xin et al, 2012;Zhao et al, 2012). Zhao et al, 2012).…”

“…Previous work reports the use of recombinant or natural hirudin in the treatment of venous congestion in animal models (Duzgun et al, 2014;Guo-Qian et al, 2012;Ying-Xin et al, 2012;Zhao et al, 2012). Zhao et al, 2012). Furthermore, intravenous injection of recombinant hirudin in regional flaps in rabbits has been reported to increase surface area survival compared with injection of low molecular weight heparin or no injection (Duzgun et al, 2014).…”