The effect of Danazol on cephalic pedicle random pattern dorsal rat skin flap survival

xiiSUMMARYClosure of large defects on skin that is outer layer of skin is one of the mostchallenging problem on reconstructive surgery. As known that, the most suitablefunctional and aesthetic way for closure of skin defects are to use flaps. But flapswhich used for large skin defects lenght are limited. As planned flap s height lenghtens,flap surviving decreases. In this situation, necrosis and tissue lost is encorded.Combination of ischemia, inflammation, and symphatectomy as adeuquatenutritional circulation is not provided, it is proposed that injury of flap becomesirreversible.When flap necrosis occurs, repetitive dressing changes that take for a long timeand also maintaining secondary operation are necessary. This condition increasesovernight stay in hospital, morbidity and cost. To prevent this problems, symphatolyticagents and anticoagulans which increases blood flow and also agents that changesreolytic property of blood are used. Moreover, cell membrane stabilization is tried to bemaintained.In this study, danazol is used for increasing survival of flap by decresingdevelopment of necrosis on distal part of random pattern skin flap. In this study, 250-300 gr in weight female Spraque Dawley rats were used. Rats were divided into twogroups as group one and two that each group composed of ten rats. Anesthesia wasprovided by applying IM 90 mg/kg Ketamine HCL (ketelar 50 mg/mlt 10 ml flk PhizerWarner Lambert) and 10 mg/kg Xylasine HCL (Rompun 50 ml Bayer) intramuscular.Random pattern skin flap 2.5x8 cm in height which includes panniculosis carnosus andtheir pedicles on side of cephalic part were elevated on the dorsum of the rats. Skin flapwas sutured with continue with 4/0 atravmatik silk suture. This procedure were appliedto each groups. Isotonic NaCI (izotonik sodyum klorür %0.9 1000 mltEczac ba ,Batter) for placebo was given to rats by the way of gavaj preoperative andpostoperative first hour dating from first day along seven days. At postoperative seventhday, all of the flaps necrosis areas were measured by milimetric paper and wererecorded. Surviving flap areas were divided into total flap area and found out theirpercentage. Student s t test was used to evaluate and p<0.05 value was accepted asstatistical meaningfulness border. To point out danazol s effect; at postoperativexiiiseventh day, biopsi taken from necrosis and living tissue border and histopatologicevaluation were made.At postoperative seventh day, danazol group was compared with control groupmacroscopically. In danazol group, flap necrosis was less and surviving flap area wasmore. Flaps surviving areas percentages in two groups which were evaluated byStudent s t test were higher in danazol group statistically.As a result, danazol increases random pattern skin flap survival slightly.Danazol can decrease random pattern skin flap necrosis due to the fact that danazol hasanticoagulant and anti-inflammation property. However, it increases its side effects dueto the fact that it causes different effects in most of organs by various physiologicalmechanisms. This condition is its disadvantage. It might be the advantage of the drugthat anticoagulant and anti-inflammation effect change depending upon its dose. Forthis reason, the studies should continue to find out dose interval that seen less sideeffect and also to provide flap survival.Key words: Danazol, skin flap, survival