Efeitos da nitroglicerina tÃpica sobre a Ãrea viÃvel de retalhos prÃ-fabricados por implante vascular em ratos

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

The mecanism that results in skin flap failure is yet not completely known. Contrary to the conflicting results observed with the use of drugs, the delay phenomenon provides an increase in the skin flap viables areas, which are effective and trusted. If the delay phenomenon were fully understood, perhaps this information could be used to create an immediate chemical delay in the threatened flap. The purpose of this study was: to study the effect of local nitroglycerin over the viable area of a prefabricated flap model for vascular implant in rats, and to analyze the mechanism of delay phenomenon applied to these models under local nitroglycerin. Forty Wistar rats underwent implant of femoral pedicle in the under skin region of the abdominal wall. The animals were divided in four groups of ten rats that: group 1 âwithout surgical delay procedure and local nitroglycerin; group 2 â with simultaneously surgical delay procedure, but without local nitroglycerin; group 3 â without surgical delay procedure, but with local nitroglycerin; and group 4 â with simultaneously surgical delay procedure and local nitroglycerin. Nitroglycerin was released via dermis under skin, through a semi permeable membrane of a device for drug constant releasing for seven days. The extensions of the viable areas among the groups were demarked, and the percentages of the viable areas, in relation to the total flap, were calculated using the AutoCAD R 14. The mean percentage value of the viable area reached 8.9% in the group that underwent solely vascular implantation; this value was 49.4% in the group that underwent vascular implantation with simultaneously surgical delay procedure; it was 8.4% in the group that underwent vascular implantation and received local nitroglycerin; and it was 1.1% in the group that underwent vascular implantation with simultaneous surgical delay procedure and local nitroglycerin. There were significant differences among the four experimental groups as regard to the distribution of viable areas percentages values, p <0.001 (Kruskal-Wallis). These differences occur between groups 1 and 2 (p =0.005); 1 and 4 (p = 0.024); 2 and 3 (p = 0.003; and 2 and 4 (p = 0.001). These results give support to the hypothesis that the closure of the arterial venous channels is responsible for the phenomenon of surgical delay procedure, and allow the conclusion that local nitroglycerin did not induce an increase of the prefabricated viable flap areas by vascular implantation; and that the local nitroglycerin decrease the viable flap areas that underwent delay surgical procedures

ASSUNTO(S)

nitroglicerina delay procedure prefabricated flap nitroglycerin cirurgia autonomizaÃÃo retalho prÃ-fabricado

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