Bas S, Ucak R, Sizmaz M, Hascicek S, Karsidag SH. Perivascular Injections of Botulinum Toxin Type A Versus Low Concentration of Ethanol.
J Surg Res 2022;
269:218-228. [PMID:
34607144 DOI:
10.1016/j.jss.2021.08.023]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/16/2021] [Accepted: 08/30/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND
This study aimed to investigate the effect of low concentration ethanol in increasing flap viability by perioperative perivascular application and compared it with that of botulinum toxin type A (BTX-A).
MATERIALS AND METHODS
Twenty-seven Wistar albino rats weighing 300-350 g were used in this study. The subjects were randomly divided into three equal groups: group E (ethanol, n = 9), group B (BTX-A, n = 9), and group S (saline, n = 9). In rats, the dorsal multi-territory perforator flap was elevated, and the agents were injected. In postoperative 1 wk, flap viability and vascular endothelial growth factor levels were evaluated. Also, blood flow, microvascular density, and inflammation degree of both choke zones were assessed.
RESULTS
The mean flap survival area and vascular endothelial growth factor level were significantly higher in group E than in group B and S (P < 0.001). Similarly, blood flow (first choke zone, P < 0.012, and second choke zone, P < 0.001) and microvascular density (first choke zone and second choke zone, P < 0.001) were found to be higher in Group E compared to Group B and S in the evaluation performed from both choke zones. Also, significant inflammation was detected in the ethanol group.
CONCLUSIONS
The positive effects of BTX-A on flap viability were achieved with a low concentration of ethanol. The fact that a low concentration of ethanol increases blood flow, angiogenesis, and flap viability more than BTX-A in the first postoperative week indicates that it can be an alternative agent for perioperative use.
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