Prevention of unfavourable effects of cigarette smoke on flap viability using botulinum toxin in random pattern flaps: An experimental study |
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Authors: | Hikmet Karayel Burak Kaya Muzaffer Caydere Ahmet Terzio?lu Gürcan Aslan |
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Affiliation: | 1.Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara Training and Research Hospital, Ankara, Turkey;;2.Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara University Faculty of Medicine, Ankara, Turkey;;3.Department of Pathology, Ankara Training and Research Hospital, Ankara, Turkey |
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Abstract: | BACKGROUND:There are numerous clinical and experimental studies reporting unfavourable effects of cigarette smoke on skin flaps.OBJECTIVE:To investigate whether unfavourable effects of cigarette smoke on flap survival could be reduced by botulinum toxin type A.METHODS:Twenty-eight male Wistar albino rats (15 months of age, mean weight 210 g [range 180 g to 230 g]) were included. They were divided into four groups of seven animals each. The control group underwent the surgical procedure alone. Surgical procedure was performed after administration of botulinum toxin type A in the botulinum toxin (BTX) group, after exposure to cigarette smoke in the cigarette smoke (CS) group, and after BTX type A administration and exposure to CS in the CS+BTX (CS+BTX) group. Random pattern cutaneous flaps (3 cm × 9 cm) were elevated from the dorsum of all rats. Necrosis area was calculated in percentages (%) using Image J computer software. Tissue samples were examined histopathologically.RESULTS:The mean necrotic area in the control group (26%) and in the BTX group (21%) were similar (P=0.497), whereas administration of BTX type A significantly decreased flap necrosis area in the rats exposed to CS (the mean necrosis areas were 41.5% in the CS group, and 26% in the CS+BTX group; P<0.001). Histopathological examination findings corroborated the unfavourable effects of CS and preventive effects of BTX type A.CONCLUSION:Preoperative administration of BTX significantly enhanced flap viability in the rats exposed to CS. Further human studies are warranted to verify whether BTX type A could be used as an agent to reduce the risk of flap necrosis in patients who smoke. |
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Keywords: | Botulinum toxin type A Flap Flap survival Smoking |
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