Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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The Effect of Botulinum Toxin-A on the Survival of Random-Pattern Cutaneous Flap in Rat

보튤리눔 톡신-A가 백서의 임의 피판 생존율에 미치는 영향

  • Kim, Young Seok (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine) ;
  • Lee, Chae Su (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine) ;
  • Yoo, Won Min (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine) ;
  • Tark, Kwan Chul (Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine)
  • 김영석 (연세대학교 의과대학 성형외과학교실, 인체조직복원연구소) ;
  • 이재수 (연세대학교 의과대학 성형외과학교실, 인체조직복원연구소) ;
  • 유원민 (연세대학교 의과대학 성형외과학교실, 인체조직복원연구소) ;
  • 탁관철 (연세대학교 의과대학 성형외과학교실, 인체조직복원연구소)
  • Received : 2008.02.27
  • Published : 2008.07.10
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Abstract

Purpose: Botulinum toxin type A(BoTA) can block the release of vasoconstriction cotransmitters as well as acetylcholine in nerve terminal. The authors observed that BoTA increases flap survival by preventing sympathetic collapse of peripheral vessels. Methods: 10 Sprague Dawley rats were divided into control(n=5), and BoTA group(n=5). $3{\times}10cm$ sized random pattern cutaneous flaps were elevated on the dorsal side in both groups. In BoTA group, BoTA was injected into the flap via intradermal to subdermal route, 7 days before the flap elevation. Flap survival rates (survival area/total area) were measured 7 days after the elevation. Cutaneous blood flow was measured in proximal, middle and distal compartments of the flap using laser Doppler flowmetry initially, preoperatively, at immediate postoperation, and 7 days after flap elevation, respectively. Histological examination was performed 7 days after the flap elevation. The number and shape of the vessels were evaluated under microscope. Results: Mean flap survival was $53.18{\pm}6.58%$ in control group and $93.79{\pm}6.06%$ in BoTA group, displaying statistically significant difference(p=0.0008, p<0.05). In the control group, blood flow to the middle and distal compartments of the flap decreased significantly immediately after flap elevation. In the BoTA group, blood flow to the middle compartment did not decrease(p=0.002) and slightly decreased in the distal compartment(p=0.001). Cutaneous blood flow was significantly higher in all compartments of the flap in BoTA group than in control group, 7 days after the flap elevation. In histopathologic examination, greater number of vessels were noted in the BoTA group than in the control group. Conclusion: Botulinum toxin A can increase the survival of the random pattern cutaneous flap in rats by preventing the sympathetic collapse of peripheral vessels.

Keywords

Acknowledgement

Supported by : 연세대학교

References

  1. Huemer GM, Wechselberger G, Otto-Schoeller A, Gurunluoglu R, Piza-Katzer H, Schoeller T: Improved dorsal random-pattern skin flap survival in rats with a topically applied combination of nonivamide and nicoboxil. Plast Reconstr Surg 111: 1207, 2003 https://doi.org/10.1097/01.PRS.0000047404.28025.C5
  2. Cordivari C, Misra VP, Catania S, Lees AJ: New therapeutic indications for botulinum toxins. Mov Disord 19(Suppl 8): S157, 2004 https://doi.org/10.1002/mds.20071
  3. Bhidayasiri R, Truong DD: Expanding use of botulinum toxin. J Neurol Sci 235: 1, 2005 https://doi.org/10.1016/j.jns.2005.04.017
  4. Rohrich RJ, Janis JE, Fagien S, Stuzin JM: The cosmetic use of botulinum toxin. Plast Reconstr Surg 112(5 Suppl): 177S, 2003 https://doi.org/10.1097/01.PRS.0000066171.65354.AE
  5. Klein AW: The therapeutic potential of botulinum toxin. Dermatol Surg 30: 452, 2004 https://doi.org/10.1111/j.1524-4725.2004.30118.x
  6. Simpson LL: The origin, structure, and pharmacological activity of botulinum toxin. Pharmacol Rev 33: 155, 1981
  7. Eleopra R, Tugnoli V, Quatrale R, Rossetto O, Montecucco C: Different types of botulinum toxin in humans. Mov Disord 19(Suppl 8): S53, 2004 https://doi.org/10.1002/mds.20010
  8. Rizo J, S?dhof TC: Mechanics of membrane fusion. Nat Struct Biol 5: 839, 1998 https://doi.org/10.1038/2280
  9. Brin MF: Botulinum toxin: chemistry, pharmacology, toxicity, and immunology. Muscle Nerve Suppl 6: S146, 1997
  10. Naumann M, Lowe NJ: Botulinum toxin type A in treatment of bilateral primary axillary hyperhidrosis: randomized, parallel group, double blind, placebo controlled trial. BMJ 323: 596, 2001 https://doi.org/10.1136/bmj.323.7313.596
  11. Morris JL, Jobling P, Gibbins IL: Botulinum toxin A attenuates release of norepinephrine but not NPY from vasoconstrictor neurons. Am J Physiol Heart Circ Physiol 283: H2627, 2002 https://doi.org/10.1152/ajpheart.00477.2002
  12. Morris JL, Jobling P, Gibbins IL: Differential inhibition by botulinum neurotoxin A of cotransmitters released from autonomic vasodilator neurons. Am J Physiol Heart Circ Physiol 281: H2124, 2001 https://doi.org/10.1152/ajpheart.2001.281.5.H2124
  13. Linderoth B, Gunasekera L, Meyerson BA: Effects of sympathectomy on skin and muscle microcirculation during dorsal column stimulation: animal studies. Neurosurgery 29: 874, 1991 https://doi.org/10.1227/00006123-199112000-00012
  14. Banbury J, Siemionow M, Porvasnik S, Petras S, Zins JE: Muscle flaps' Triphasic microcirculatory response to sympathectomy and denervation. Plast Reconstr Surg 104: 730, 1999 https://doi.org/10.1097/00006534-199909030-00018
  15. Celik E, Tercan M, Uzunismail A, Saglam A: Versatility of botulinum toxin A: a use in stabilization of pedicled muscle flaps. Plast Reconstr Surg 117: 462, 2006 https://doi.org/10.1097/01.prs.0000197214.57838.9b