Investigation of the effects of calcium dobesilate and pentoxyflavin on the viability of random pattern McFarlane flap in rats

Flaps are used in the repair of different tissue defects that may cause various functional and aesthetic losses in the human body and are one of the basic operations of plastic surgery. One of the most crucial complications that may occur in flep surgery is panviap or total flep necrosis. Flap necrosis is an important issue that may increase patient morbidity, prolong hospitalisation and cause recurrent operations. Therefore, many experimental studies have been conducted on flep viability and medical agents have been used. Many of these medical treatments used in these studies are antioxidative agents, peripheral vasodilators, antithrombotic agents, etc. The aim of our study was to investigate the effect of Calcium Dobesilate (CaD), which has both antioxidant and peripheral vasodilator effects, on random flep viability and to compare its effects with pentoxifylline (PTX), which is also known to have positive effects, and to evaluate the results of combined treatments of these drugs. In this study, 40 Sprague Dawley rats aged between 2-4 months and weighing 200-250 g were used as subjects. A cranial based McFarlane flep of 9x3 cm in size was designed in a random pattern on the back of the rat. In the study, 4 groups were determined as control n (10), CaD n (10), PTX n (10) and CaD+PTX n (10). The control group received intraperitoneal saline, the CaD group received calcium dobesilate 50mg/kg/day by oral gavage every day for 7 days from day 0 of the experiment, and the PTX group received pentoxifylline 40mg/kg/day intraperitoneally every day for 7 days. CaD+PTX group received the drugs in combination. The subjects were sacrificed on the 7th day and digital photographs were taken for topographic examination and samples were taken for histopathological examination. The ratio of flep living area to flep final total area was found to be 27,214±7,886 in the control group, 66,643±15,110 in the CaD group, 70,000±10,006 in the PTX group, and 79,949±6,767 in the CaD+PTX group. Histopathological parameters showed that there were significantly more severe oedema, necrosis, PMNL increase, fibroblast proliferation and vascularisation increase in the control group compared to the drug treated group. These histopathological parameters also revealed that there were statistical differences between the combined group and the groups in which the drugs were administered individually in favour of the combined group. CaD had favourable effects on random skin flep nutrition. Although there was no statistically significant difference with pentoxifylline, a significant difference was found in the combined treatment. CaD , which has antioxidant, antiapoptotic, anti-inflammatory and peripheral vasodilator effects, can be preferred to increase random pattern flep survival and can be used in combination with other antioxidant and vasodilator agents. Key words: Calcium dobesilate, Pentoxifylline, McFarlane flep, flep blood supply