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J Reconstr Microsurg 2015; 31(02): 145-153
DOI: 10.1055/s-0034-1394101
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Influence of Diabetes Mellitus on Survival of Abdominal Perforator Flaps: An Experimental Study in Rats with Slowly Induced Diabetes Mellitus

Bogdan Ionut Baldea
1   Department of Plastic Surgery, Clinical Emergency County Hospital Brasov, Brasov, Romania
,
Septimiu Toader
2   Center of Experimental Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj Napoca, Cluj Napoca, Romania
,
Pavel Orbai PhD
3   Department of Clinical Endocrinology, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj Napoca, Romania
,
Simona Barsan
4   Department of Plastic Surgery, Children's Emergency Hospital Cluj Napoca, Cluj Napoca, Romania
,
Radu Olariu
5   University Hospital “Inselspital” and University of Berne, Bern, Switzerland
,
Dan Ovidiu Grigorescu
1   Department of Plastic Surgery, Clinical Emergency County Hospital Brasov, Brasov, Romania
,
Marius Penciu
6   Department of Pathology, Clinical Emergency County Hospital Brasov, Brasov, Romania
,
Andras Laszlo Nagy
7   Department of Pathology, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
,
Alexandru Valentin Georgescu
8   Department of Plastic Surgery, Clinical Recovery Hospital Cluj Napoca, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Cluj, Romania
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Publikationsverlauf

17. Februar 2014

06. August 2014

Publikationsdatum:
31. Oktober 2014 (online)

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Abstract

Background Lower limb ulcers are a major source of morbidity and mortality in diabetic patients. Surgical coverage of these wounds is fraught with a high complication rate. Although clinically perforator flaps lead to good results in diabetic patients, there is little experimental data to support this finding.

Methods A total of 60 Wistar rats were randomly assigned either to the diabetic (n = 30) or control (n = 30) group. Diabetes was induced by streptozotocin injection at 50 mg/kg body weight and was confirmed by blood glucose levels > 180 mg/dL preoperatively. In all rats, a cranial epigastric artery perforator flap was raised. At postoperative day 7, all flaps were raised, photographed by digital planimetry, and analyzed histologically.

Results Mean glycemic levels preoperatively were 207.8 ± 16 in the diabetic group and 82.8 ± 5.1 in the control group (p < 0.05). Ninety percent of the flaps survived completely in the control group, compared with 66.7% in the diabetic group (p < 0.05). The mean flap survival area was lower in the diabetic group (83.3 ± 16.5%) than in the control group (96 ± 4%). There were significantly more perioperative complications in the diabetic group (46.7%) than in the control group (16.7%), but these did not affect flap survival. Superficial ulceration appeared only in the diabetic group as a complication.

Conclusion Perforator flaps can be successfully used for coverage of cutaneous defects in a rat diabetic model. These flaps show higher complication rates in diabetic versus nondiabetic animals; however, this complication rate has little influence on flap survival.

Keywords

streptozotocin - rat - diabetes mellitus - perforator - flap
 

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