[Effects of combined natural hirudin and hyperbaric oxygen therapy on survival of transplanted random-pattern skin flap in rats].

Objective: To investigate the effect of natural hirudin combined with hyperbaric oxygen therapy on the survival of transplanted random-pattern skin flap in rats. Methods: A random-pattern skin flap in size of 10.0 cm×2.5 cm was elevated on the dorsum of 72 Sprague Dawley rats. Then the 72 rats were randomly divided into 4 groups ( n=18) according to the therapy method. At immediate and within 4 days after operation, the rats were treated with normal saline injection in control group, normal saline injection combined with hyperbaric oxygen treatment in hyperbaric oxygen group, the natural hirudin injection in natural hirudin group, and the natural hirudin injection combined with hyperbaric oxygen treatment in combined group. The flap survival was observed after operation, and survival rate was evaluated at 6 days after operation. The skin samples were collected for histological analysis, microvessel density (MVD) measurement, and evaluation of tumor necrosis factor α (TNF-α) expression level by the immunohistochemical staining at 2 and 4 days after operation. 结果: 术后各组皮瓣均出现部分坏死，其中联合组皮瓣成活最佳；术后第 6 天高压氧组、水蛭素组及联合组皮瓣成活率明显高于对照组，联合组高于水蛭素组、高压氧组，比较差异有统计学意义（ P 0.05）。组织学观察示，术后第 2 天，水蛭素组、高压氧组及联合组微血管结构较对照组多，各组均见炎性细胞浸润；第 4 天，高压氧组、水蛭素组及联合组中仍可见较多微血管形成，对照组中见大量炎性细胞浸润，其余各组炎性细胞均较术后第 2 天时明显减少。免疫组织化学染色观察示，术后第 2 天，高压氧组、水蛭素组及联合组 MVD 均显著高于对照组、TNF-α 蛋白表达量显著低于对照组（ P 0.05）。术后第 4 天，高压氧组、水蛭素组及联合组 MVD 均显著高于对照组，联合组及水蛭素组高于高压氧组，比较差异有统计学意义（ P 0.05）；高压氧组、水蛭素组及联合组 TNF-α 蛋白表达量显著低于对照组，联合组低于水蛭素组及高压氧组，比较差异有统计学意义（ P 0.05）。. Conclusion: Hyperbaric oxygen and natural hirudin therapy after random-pattern skin flap transplantation can improve the survival of flaps. Moreover, combined therapy is seen to exhibit significant synergistic effect. This effect maybe related to promotion of angiogenesis and the reduction of inflammation response.