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. 2016 Nov;33(6):645-651.
doi: 10.5152/balkanmedj.2016.150981. Epub 2016 Nov 1.

Use of Systemic Rosmarinus Officinalis to Enhance the Survival of Random-Pattern Skin Flaps

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Free PMC article

Use of Systemic Rosmarinus Officinalis to Enhance the Survival of Random-Pattern Skin Flaps

Bilsev İnce et al. Balkan Med J. .
Free PMC article

Abstract

Background: Skin flaps are commonly used in soft-tissue reconstruction; however, necrosis can be a frequent complication. Several systemic and local agents have been used in attempts to improve skin flap survival, but none that can prevent flap necrosis have been identified.

Aims: This study aims to determine whether the use of systemic Rosmarinus officinalis (R. officinalis) extract can prevent flap necrosis and improve skin flap recovery.

Study design: Animal experimentation.

Methods: Thirty-five Wistar albino rats were divided in five groups. A rectangular random-pattern flaps measuring 8×2 cm was elevated from the back of each rat. Group I was the control group. In Group II, 0.2 ml of R. officinalis oil was given orally 2h before surgery. R. officinalis oil was then applied orally twice a day for a week. In Group III, R. officinalis oil was given orally twice a day for one week before surgery. At the end of the week, 0.2 mL of R. officinalis oil was given orally 2 h before surgery. In Group IV, 0.2 mL of R. officinalis oil was injected subcutaneously 2 h before surgery. After the surgery, 0.2 mL R. officinalis oil was injected subcutaneously twice a day for one week. In Group V, 0.2 mL R. officinalis oil was injected subcutaneously twice a day for one week prior to surgery. At the end of the week, one last 0.2 mL R. officinalis oil injection was administered subcutaneously 2 h before surgery. After the surgery, 0.2 mL R. officinalis oil was injected subcutaneously twice a day for one week.

Results: The mean percentage of viable surface area was significantly greater (p<0.05) in Groups II, III, IV, and V as compared to Group I. Mean vessel diameter was significantly greater (p<0.05) in Groups II, III, IV, and V as compared to Group I.

Conclusion: We have determined that, in addition to its anti-inflammatory and anti-oxidant effects, R. officinalis has vasodilatory effects that contribute to increased skin flap survival.

Keywords: Rosmarinus officinalis; flap survivability; rosemary; tissue defect.

Conflict of interest statement

No conflict of interest was declared by the authors.

Figures

FIG. 1
FIG. 1
The flaps in Group I a week after surgery
FIG. 2
FIG. 2
The flaps in Group II a week after surgery
FIG. 3
FIG. 3
The flaps in Group III a week after surgery
FIG. 4
FIG. 4
The flaps in Group IV a week after surgery
FIG. 5
FIG. 5
The flaps in Group V a week after surgery
FIG. 6
FIG. 6
a–e. ×400, H&E; appearance of largest blood vessels in the proximal flap in Group I (a). ×400, H&E; appearance of largest blood vessels in the proximal flap in Group II (b). ×400, H&E; appearance of largest blood vessels in the proximal flap in Group III (c). ×400, H&E; appearance of largest blood vessels in the proximal flap in Group IV (d). ×400, H&E; appearance of largest blood vessels in the proximal flap in Group V (e)

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