Dual Preconditioning Effect of Dexamethasone and Epinephrine on TRAM flap Survival in Rats.

Kim, Jae Woo; Kim, Jun Hyuk; Ahn, Hyoung Sik; Shin, Ho Sung; Choi, Hwan Jun; Lee, Young Man

Search: J Korean Soc Plast Reconstr Surg Search

CLOSE

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2007;34(2):163-168.
Published online March 1, 2007.

Dual Preconditioning Effect of Dexamethasone and Epinephrine on TRAM flap Survival in Rats.

Jae Woo Kim, Jun Hyuk Kim, Hyoung Sik Ahn, Ho Sung Shin, Hwan Jun Choi, Young Man Lee

Department of Plastic and Reconstruction Surgery, College of Medicine, Soon Chun Hyang University, Seoul, Korea. psdoctorkjh@hanmail.net

Abstract

PURPOSE
The flap delay is a widely used technique to increase the flap survival. Dexamethasone is a well-known drug to have a positive impact on the flap survival. The objective of this study is to investigate the dual synergic effect of epinephrine as a chemical delay agent plus dexamethasone on the TRAM flap survival in rat model. METHODS: Forty Sparague-Dawley rats were divided into 4 groups evenly and a right inferior epigastic vessel pedicled TRAM flap, sized 5.0x3.0cm, was elevated on each upper abdomen. In the control group(N=10), 2 ml saline was injected on transverse abdominis muscle for a week before the flap elevation. In surgical delay group(N=10) all superior pedicles and left inferior pedicle were ligated a week before the flap elevation. In epinephrine group (N=10), 1 : 50000 epinephrine mixed saline was injected to transverse abdominis muscle every day for a week before flap elevation. In epinephrine plus dexamethasone group (N=10), the same procedure as that of epinephrine group was conducted for a week and 2.5 ml/kg dexamethasone was injected transverse abdominis muscle 2 hours before the flap elevation. On the seventh day after flap elevation, the survival area of flaps were measured and the vessel numbers in upper dermis of flap were counted through histologic slides.
RESULTS
The results were as follows: the mean percentage of the flap survival area of surgical delay group (60.5+/-2.44%), epinephrine group (75+/-4.43%), and epinephrine plus dexamethasone group (87+/-1.94%) were higher than that of the control group (35+/-6.06%) significantly(p<0.05). In case of the vessel number though histologic slides, epinephrine group (79.3+/-5.57) and epinephrine plus dexamethasone group (96.3+/-14.05) were higher than that of the control group (44.8+/-8.82) significantly(p<0.05), but the surgical delay group (54+/-4.23) showed no significant difference (p>0.05) compared to that of the control group.
CONCLUSION
The results indicated that epinephrine plus dexamethasone injection before the flap elevation could be used to increase the TRAM flap survival area in rat model.

Keywords: Epinephrine; Dexamethasone; Dual preconditioning effect

TOOLS