Evaluation of the effects on the causes of omentin flap viability

Closure of the large skin defects is one of the most important challenges in plastic surgery. In closure of large defects, as the length of the flaps increases, the area of the flaps? viable areas may decrease. Therefore, necrotic areas develop on the distal part of the flaps. Chemical, physical and surgical modifications have been performed to increase flap viability. Omentin makes vasodilatation on the vessels. Omentin increases the endothelial NO with inducting secretion of endothelial NO sentaz. Though there are studies on the effects of omentin in the human body, there are no papers in literature addressing the role of omentin on flap survival. In this study, we aimed to evaluate the effects of locally administered omentin, on rats? dorsal McFarlane flap survival. In this study, female, adult, 250-350 grams weighted Sprague-Dawley rat was choosen as experiment animal. Animals were divided into three groups I ? Control, II ? omentin treatment 1 week before the flap surgery, III ? omentin treatment 2 days before the flap surgery and the same day with the surgery. In group 2 and 3, 1 week before the surgery and 2 days before and the same day with the surgery respectively, omentin has been administered to flap areas locally with dental injector in one entrance point due to proximal part of the flap. 300 ng/ml omentin was injected in only 1/3 distal part of the flap. After the anesthesia, 3x10 cm sized dorsal, caudal pedicled McFarlane flap was elevated and sutured back into same area. On postoperative 7th day viable areas were calculated macroscopically. Biopsies were obtained from the middle part of the flaps for histopathological examination. Endothelial NO sentaz was analyzed using ELISA test. Number of neutrophils was analyzed using hematoxilen-eosine and mason. And also Vascular Endothelial Growth Factor (VEGF) painted endotheliums were analyzed for angiogenesis. All subjects were well tolerated the surgical procedures. Each rat?s tissue biopsies were evaluated for inflammation, edema and hemorrhage. All data were analyzed statistically for evaluation of effects of omentin on flap survival. There was a statistically significant difference between treatment group and the control group, according to percent of viable flap areas, thickness of epidermis neoangiogenesis and eNOS expressions. There was no statistically significant difference between treatment groups in the examined parameters except the percent of flaps? viable areas. In treatment groups? neutrophil invasion was decreased compared to control group, but it was not statistically significant. Omentin is a recombinant product obtained from omental tissue, and is easily found having no side effect profiles. Omentin effects as vasodilator and anti-inflammatory. In this study we showed that this enhanced flap viability was significant. We think that, with further investigations, omentin will be used safely in enhancing flap viability. Keywords: flap, omentin, e-NO sentaz