From: Pharmacological and cell-based treatments to increase local skin flap viability in animal models
Pharmacologic therapy | MoA | RoA | Animal model | Treatment protocol | References |
---|---|---|---|---|---|
Low-molecular-weight heparin | Enhancement of Antithrombin III | Subcutaneous injection | Rabbit congested pedicled flaps | Single immediate post-operative injection | Miyawaki et al. [9] |
Hirudin | Enhancement of Antithrombin III (contains the active ingredient heparinoid) | Subcutaneous injection | Rat caudally-based random dorsal flap | Immediate injection after surgery and again on postoperative days 3 and 5, 1–3 cm proximal to the distal limit of the flap | Yingxin et al. [10] |
Hirudoid | Activation of anti-thrombin III (contains the active ingredient heparinoid), Inhibition of hyaluronidase, Stimulation of growth factor production such as VEGF and PDGF | Topical cream | Rat caudally based dorsal flaps | Post-operative application for 9Â days | LivaoÄŸlu et al. [8] |
Bivalirudin | Direct inhibition of thrombin, enhancement of anticoagulation | Intraperitoneal injection | Rat random dorsal flaps | Post-operative injection once a day for 7Â days | Cai et al. [11] |
Activated protein C | Inactivation of serine protease clotting factor Va, VIIIa, Xa, and tissue factor. Inhibition of fibrinolysis | Intravenous injection | Rat cranially-based dorsal cutaneous flap | Injections in 3 groups: postoperative, late preoperative, and early preoperative | Bezuhly et al. [12] |
Platelet-rich plasma gel | Concentrated form of platelets, growth factors PDGF, TGF-β, platelet-derived epidermal growth factor, platelet-derived angiogenesis factor insulin-like growth factor-1, and platelet factor-4, stimulate the mesenchymal cells and epithelial cells proliferation, and increase collagen and matrix synthesis, fibrinogen, fibronectin, and vinculin | Gel application on the wound | Rats cranially-based dorsal random flap | PRP gel was applied on the wound surface and then the flap was sutured | Chai et al. [13] |
Subcutaneous injection | Rabbit cranially-based dorsal random-pattern flap | Post-operative injection once | Wang et al. [14] |