POSTISCHEMIC FLAP WASHOUT WITH HYDROXYETHYL STARCH (HAES) AND ITS BENEFICIAL EFFECT ON THE NO-REFLOW PHENOMENON IN RAT SKIN ISLAND FLAPS

This study investigated the possible effect of hydroxyethyl starch (HA ES) as a postischemic perfusion washout on survival of skin flaps. For ty-eight, male, Sprague-Dawley rats were used in this experiment. A 4x 6 cm unilateral island skin flap based on the superficial inferior epi gastric artery and vein was raised. The femoral neurovascular bundle s upplying the flap pedicle was also dissected free. The flaps were divi ded into four groups, each consisting of 12 rats. Group 1 (Nonishemic control); Group 2 (Control) - no perfusion washout; Group 3 (Saline) - postischemic washout with normal saline solution; Group 4 (HAES) - po stischemic washout with hydroxyethyl starch 10% (HAES) solution. The f laps were subjected to 11 hours of warm ischemia. Thirty minutes prior to the completion of the ischemic period, the flaps were perfused wit h normal saline solution in group 3 and with HAES in group 4. The perc entage of flap survival was assessed on postoperative day 7. Statistic al analysis was performed using the Student's t-test. Flap survival ra tes for Group 4 (HAES) were significantly greater than Group 2 (Contro l nonperfusion washout) and Group 3 (saline solution) (p<0.001). This is the first study to investigate the effect of HAES on skin flap surv ival based on the results, HAES solution may be useful in clinical pra ctice.