Akademik Veri Yönetim Sistemi
4. Uluslararası İzmir Demokrasi Üniversitesi Tıp Kongresi, İzmir, Türkiye, 9 - 11 Kasım 2022, ss.78
Introduction and Purpose: Venous insufficiency problems are one of the most frequent complication in flap surgeries. Various pharmacological agents have been studied in many studies to overcome this problem. Apixaban, which provides factor Xa inhibition, is used as an antithrombotic agent. In our study, the effectiveness of this agent in flap venous problem was investigated.
Material and Method: Twenty-four Wistar albino rats were divided into three groups as 8 sham, control and experimental groups. In this experimental model, venous thrombosis that can occur during free tissue transplantation in the clinic and subsequent exploration are simulated. After the removal of the pedicled epigastric flap, the 2-hour period was accepted as the primary global ischemia process and the artery and vein were clamped. The next 24 hours were considered as the reperfusion period. During secondary venous ischemia, the veins of the flap were clamped for 4 hours. After the 7-day reperfusion period, the rats were sacrificed and flap viability was evaluated macroscopically on a millimetric paper with transparent acetate and histopathologically. Sham group was exposed to prime global ischemia only, control and experimental groups were included in the whole process. The control group was treated with physiological saline from 6 hours before the secondary venous ischemia to the 7th day, and the experimental group was treated with apixaban during the same period. Data were evaluated biostatistically with Kruskal Wallis and Mann Whitney U test.
Results: There was no significant difference in the percentages of necrotic areas macroscopically (p=0.390). In the histopathological evaluation, no significant difference was found in terms of necrosis, edema, thrombus, vascular congestion and inflammation data. When the effect of apixaban treatment on bleeding time was examined, it was observed that it increased significantly in the experimental group compared to the other groups.
Discussion and Conclusion: The use of apixaban, which is usually used in Cardiology and Orthopedics practices, in flap venous problems in Plastic Surgery did not make a significant difference macroscopically and histopathologically. Although apixaban significantly prolonged bleeding time in rats, it had no significant effect on flap viability.