ABSTRACT
Objective:To explore the effect of intravascular sodium nitroprusside (SNP) combined with hyaluronidase (HAase) plus urokinase (UK) in treating rat abdominal wall skin flap ischemia caused by HA induced artery embolism, and to compare the difference between thrombolysis with and without addition of sodium nitroprusside.Methods:Forty male Sprague-Dawley rats were injected with 10 μl of hyaluronic acid (HA) into the left inferior epigastric arteries, constructing the superficial epigastricl artery skin flap ischemic model in rats. The rats were randomly divided into four groups: a control group, and experimental groups A, B and C. Control and experimental groups A, B and C were treated with the following solutions 45 minutes after hyaluronic acid injection: physiological saline plus glucose was injected into the rats (control group); hyaluronidase (HAase) plus glucose injection was injected into the rats (experimental group A), hyaluronidase (HAase) plus urokinase (UK) was injected into the rats (experimental group B), hyaluronidase (HAase), urokinase (UK) plus sodium nitroprusside were injected into the rats (experimental group C). The changes of flaps were observed at 0 min, 3 days, 5 days and 7 days after operation. The difference of the area percentage of unperfused flap in the four groups was compared 7 days after operation. This study was carried out from July 2020 to March 2021 in the Medical Laboratory Animal Center of Weifang Medical University.Results:The unperfused area of flaps for the control group, experimental groups A, B and C were (100.00±0.00) %, (44.68±7.90)%, (34.01±8.77)% and (24.12±4.58)%, respectively. In the experimental group C, the scabby necrosis area was smaller than that of the experimental group A ( P<0.05); in the experimental group C, the scabby necrosis area was smaller than that of the experimental group B ( P<0.05); in the experimental group B, the scabby necrosis area was smaller than that of the experimental group A ( P<0.05). HE staining revealed that size and density of the embolus was significantly decreased after the addition of sodium nitroprusside. Conclusions:Sodium nitroprusside combined with hyaluronidase and urokinase can effectively improve the ischemia of the flap caused by HA induced artery embolism, increase the tissue perfusion, and reduce the necrotic area of the flap.
ABSTRACT
Objective:To explore the relationship among the supratrochlear and supraorbital neurovascular bundles and the corrugator muscle, in order to provide anatomical basis for eyebrow operations.Methods:From July to October 2019, the upper eyelids and forehead of 10 adult skull specimens (20 sides) were dissected layer by layer in the anatomy laboratory of Weifang Medical College. The line of bilateral inner canthus was taken as the X-axis and the facial midline as the Y-axis to establish the coordinate system. The coordinate parameters of supratrochlear nerve, supratrochlear artery, medial branch of supraorbital nerve, lateral branch of supraorbital nerve and supraorbital artery were measured to obtain the range of its trajectory, and their level and their adjacent relationship with the corrugator muscle were observed.Results:The corrugator muscle started from the upper part of the nasal process of the frontal bone near the medial margin of the orbit and was (4.32±0.98) mm from the midline. The base of the corrugator muscle start was (9.91±1.41) mm wide. The corrugator muscle run obliquely upward, through orbicularis oculi muscle and frontal muscle, and stopped at subcutaneous of the outer 1/3 of eyebrow. The trapezoid area was composed of the line of 15 mm above the inner canthus line, (16.58±1.70) mm and (16.17±1.42) mm from the facial midline as the lower base and the line of 30 mm above the inner canthus line, (13.74±1.54) mm and (14.21±2.42) mm from the facial midline, which was the dangerous area for the supratrochlear neurovascular bundles walking in corrugator muscle. The trapezoid area was composed of the line of 22.5 mm above the inner canthus line, (26.03±1.55) mm and (28.11±2.46) mm from the facial midline as the lower base and the line of 40 mm above the inner canthus line, (31.23±3.19) mm and (38.20±2.94) mm from the facial midline, which was the dangerous area for the supraorbital neurovascular bundles.Conclusions:Familiar with the relationship among the supratrochlear and supraorbital neurovascular bundle and the corrugator muscle can avoid dangerous areas and reduce superficial and deep neurovascular injury during operation.