Arch Craniofac Surg.  2019 Aug;20(4):239-245. 10.7181/acfs.2019.00381.

Effect of fractional ablative carbon dioxide laser with lidocaine spray on skin flap survival in rats

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine, Daegu, Korea. yhkim@med.yu.ac.kr
  • 2Iwell Plastic Surgery, Seoul, Korea.

Abstract

BACKGROUND
Lidocaine spray is a local anesthetic that improves random-pattern skin flap survival. The fractional ablative carbon dioxide laser (FxCL) produces vertical microchannels that delivers topically applied drugs to the skin. In this study, we hypothesized that FxCL therapy would enhance the lidocaine effect to improve random-pattern skin flap survival in rats.
METHODS
McFarlane random-pattern skin flaps were elevated in 48 rats, which were divided into four groups according to treatment: FxCL+lidocaine, FxCL, lidocaine, and nontreatment (control). On postoperative day 7, necrotic flap areas, the number of capillary vessels, and neutrophil count were evaluated. Anti-rat vascular endothelial growth factor (VEGF) and CD31 antibody activity were also evaluated by immunohistochemical staining.
RESULTS
Flap survival rate was 53.41%±5.43%, 58.16%±4.80%, 57.08%±5.91%, and 69.08%±3.20% in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Mean neutrophil count in the intermediate zone excluding the necrotic tissue was 41.70±8.40, 35.43±6.41, 37.23±7.15, and 27.20±4.24 cells/field in the control, lidocaine, FxCL, and FxCL+lidocaine groups, respectively. Anti-rat VEGF and CD31 antibody activity were the highest in the FxCL+lidocaine group.
CONCLUSION
FxCL with lidocaine had a positive effect on random-pattern skin flap survival in rats. Thus, FxCL with lidocaine spray should be considered as a new treatment option to improve flap viability.

Keyword

Lasers, gas; Lidocaine; Rats

MeSH Terms

Animals
Capillaries
Carbon Dioxide*
Carbon*
Lasers, Gas*
Lidocaine*
Neutrophils
Rats*
Skin*
Survival Rate
Vascular Endothelial Growth Factor A
Carbon
Carbon Dioxide
Lidocaine
Vascular Endothelial Growth Factor A
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