Effect of Natural Hirudin on Random Pattern Skin Flap Survival in a Porcine Model

Abstract

Objective: The effect of local administration of hirudin on random pattern skin flap survival was investigated in a porcine model. Methods: Three random pattern skin flaps (4 × 14 cm) were created on each flank of five Chinese minipigs. The experimental group (10 flaps) received 20 antithrombin units of hirudin, injected subdermally into the distal half immediately after surgery and on days 1 and 2; a control group (10 flaps) was injected with saline and a sham group (10 flaps) was not injected. All flaps were followed for 10 days postoperatively. Results: Macroscopically, the congested/necrotic length in the experimental group was significantly decreased compared with the other two groups by day 3. Histopathological evaluation revealed venous congestion and inflammation in the control and sham groups from day 1, but minimal changes in the experimental group. By day 10, the mean ± SD surviving area was significantly greater in the experimental group (67.6 ± 2.1%) than in the control (45.2 ± 1.4%) or sham (48.3 ± 1.1%) groups. Conclusions: Local administration of hirudin can significantly increase the surviving area in overdimensioned random pattern skin flaps, in a porcine model.