Evaluation of the effects of benazepril hydrochloride, valsartan, and their combined use on the viability of McFarlane flap in a random pattern rat model

In this experimental study, the effects of benazepril hydrochloride, valsartan, and their combination on the viability of random-pattern flaps were investigated using the McFarlane dorsal flap model in rats. Both histopathological and macroscopic assessments were conducted. Changes in the flap tissue due to the pharmacological agents administered orally to the experimental animals were evaluated based on edema, inflammation, necrosis, and polymorphonuclear leukocyte infiltration parameters. Histopathological analysis revealed a significant reduction in inflammation, edema, and necrosis scores in both the benazepril and valsartan groups. These improvements were more prominent in the combined therapy group, indicating a synergistic effect due to their anti-inflammatory and antioxidant properties. Although an increase in the average viable flap area was observed macroscopically, this increase did not reach statistical significance. The findings suggest that pharmacological agents targeting the renin-angiotensin system (RAS) have potential in enhancing flap viability. This study supports that benazepril and valsartan, particularly when used in combination, may improve vascular resilience in surgical flaps and provide protection against ischemia-reperfusion injury. Nevertheless, the absence of statistically significant macroscopic findings requires cautious interpretation. In conclusion, this study indicates that RAS inhibitors may be promising agents in surgical flap models. However, further advanced studies with larger sample sizes, involving different flap models and incorporating biochemical parameters, are necessary to evaluate their clinical applicability. Keywords: Benazepril, Valsartan, Flap Viability, McFarlane Flap, Ischemia-Reperfusion Injury, Renin-Angiotensine-Aldosterone Inhibitors, Histopathology, Macroscopic Evaluation