Effect of Topical Nitroglycerine on the Survival of Ischemic Flow-Through Venous Flaps in Rabbits

Çoruh, Atilla; Abaci, Kamil; Günay, Galip K.

doi:10.1055/s-2004-823114

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…The last issue to be considered is the dosage of the drug administered. In previous studies, nitroglycerine was applied in the form of patches 4,5,18,22 and ointments. 7,13,37 While the dosage of the drug in grams was stated in the studies using the patch form, exact weight in grams was not mentioned in studies using the ointment form, probably due to difficulties in calculating the exact amount.…”

Section: Discussionmentioning

confidence: 99%

“…Many subsequent experimental studies confirmed this finding. [4][5][6][7] These experimental studies were followed by clinical studies and small case series that observed the benefit of nitroglycerin treatment for hypospadias treatment and peripheral necrosis. 8,9 Today, topical nitroglycerin treatment is frequently used to increase the survival of mastectomy flaps and relevant studies are ongoing.…”

Section: Introductionmentioning

confidence: 99%

“…Nitroglycerin was predicted to increase flap vascularity due to its vasodilator and antithrombotic effects. 2,3 Rohrich et al's 4 initial study on rats and pigs showed that there is an increase in flap survival with the use of nitroglycerin. Many subsequent experimental studies confirmed this finding.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Nitroglycerin Treatment Initiation Time on Survival in Partial Flap Necrosis: An Experimental Study

et al. 2022

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Background: Nitroglycerin is suggested to improve flap survival based on promising results; however, there are no data on the effectiveness of treatment initiation time. This study aimed to compare the effect of various nitroglycerin treatment initiation times on partial flap survival. Materials and Methods: The study included 50 Sprague-Dawley rats. Modified McFarlane flaps were elevated on the dorsum of each rat. Group A received placebo treatment. Groups B, C, D, and E received topical nitroglycerin 2% starting 1 day before surgery, on the day of surgery, postoperative d 2, and postoperative d 4, respectively. After 7 days, the flap survival rates were calculated. Afterward, the severity and extent of inflammation and ischemia, and the severity of edema were evaluated histologically. Results: The flap survival rate was highest in group B, followed by groups C, D, E, and A. The difference between groups B and C was not significant, whereas the difference between group B and groups A, D, and E was. In addition, the difference between groups A, D, and E was not significant. Histological analysis showed that inflammation was less severe in groups B and C than in groups A, D, and E. Ischemia was the most severe in groups A and D and was the least severe in group C. Conclusion: Topical nitroglycerin treatment increases flap survival when initiated before or on the day of surgery, but has no benefit when initiated on postsurgery d 2 or 4. Preoperative initiation of nitroglycerin treatment positively affects flap survival.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Effect of Nitroglycerin Treatment Initiation Time on Survival in Partial Flap Necrosis: An Experimental Study

et al. 2022

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The nomenclature of venous flow‐through flaps: Updated classification and review of the literature

et al. 2012

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Venous flow-through flaps (venous flaps) are useful reconstructive options, particularly in the repair of defects with segmental vessel loss. They are relatively easy to harvest and confer several benefits at the donor site. However, given that they are based on a single central vein, their survival is notoriously unreliable and they are susceptible to ischemia and venous congestion. Various designs have been suggested to improve the circulatory physiology, and hence survival, of venous flap. More recent designs involve adaptations to the arrangement and number of efferent veins draining arterialized venous flaps. The most commonly used classification system for venous flaps, proposed by Chen, Tang, and Noordhoff, does not afford adequate description of these alternate designs. This article offers a classification system that can incorporate all reported modifications to venous flaps. This simple adaptation to the classification system proposed by Chen et al. restores its usefulness in describing modern variations to venous flap design.

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Utilization of the Rat’s Tail as a Novel Model for Arterialized Venous Flap

Mallarino-Restrepo

Camuzard

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Summary: Arterialized tissues provide longevity and coverage of critically exposed tissue, and in pliable areas of the body, thin flaps are needed. Arterialized venous flaps provide all the aforementioned qualities, yet unpredictability in flap perfusion requires further investigation in experimental studies. Existing animal models are thicker in nature and rarely mimic commonly used venous flaps in clinical practice. A novel design of the rat’s tail provides an ideal model for arterialized venous flaps. Eleven venous flaps were harvested from the rats’ tail, all presenting with two parallel veins in configuration. Arterialization of veins using the femoral artery was done in either along-valve or against-valve fashion, with the purpose of testing the flap’s response to different clinical configurations. The vessel diameter and flap thickness were measured. Flap viability was monitored for 7 days after surgery to ensure stable flap viability. Thickness of the tail flap ranged from 1.0 to 1.2 mm, while the abdomen skin thickness ranged from 1.4 to 1.5 mm. The mean diameter of the lateral veins was 0.85 ± 0.08 mm, which was in between the average femoral artery diameter (mean 0.76 ± 0.1 mm) and the average femoral vein diameter (1.28 ± 0.2 mm). Four of the nine against-valve flaps achieved more than 50% flap survival, while all along-valve flaps achieved flap viability of more than 75%, as evident by indocyanine green imaging. This flap demonstrates similar properties to thin venous flaps used in clinical situations. Standardization of this model can push forth better understanding of the arterialization phenomenon in venous flaps for future studies.

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Effect of Topical Nitroglycerine on the Survival of Ischemic Flow-Through Venous Flaps in Rabbits

Cited by 4 publications

References 22 publications

The Effect of Nitroglycerin Treatment Initiation Time on Survival in Partial Flap Necrosis: An Experimental Study

The Effect of Nitroglycerin Treatment Initiation Time on Survival in Partial Flap Necrosis: An Experimental Study

The nomenclature of venous flow‐through flaps: Updated classification and review of the literature

Utilization of the Rat’s Tail as a Novel Model for Arterialized Venous Flap

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