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Medical Science Monitor Basic Research


eISSN: 1643-3750

Effects of Normovolemic Hemodilution on Survival of Skin Flaps: An Experimental Study

Canser Yilmaz Demir

Department of Plastic and Reconstructive Surgery, Yuzuncu Yıl University Faculty of Medicine, Van, Turkey

Med Sci Monit 2018; 24: ANS1434-1440

DOI: 10.12659/MSM.906160

Available online: 2018-03-09

Published: 2018-03-09


BACKGROUND: The aim of this study was to investigate the effects of various ratios of hemodilution on the survival of McFarlane’s skin flaps.
MATERIAL AND METHODS: An experimental study was performed on 42 adult male Wistar rats (weighing 260 to 305 g) allocated to a control group without any volume loss and to 6 study groups with hemodilution ratios of 5%, 10%, 15%, 20%, 25%, and 30%. In all subjects, random-pattern McFarlane’s skin flaps were uniformly elevated and re-sutured to the donor sites. The amount of necrosis was evaluated on the 7th day postoperatively and compared among the groups.
RESULTS: The amounts of flap necrosis in the groups with 5%, 10%, 15%, and 20% hemodilution ratios were significantly lower than that of the control group (p<0.001). In the 25% and 30% hemodilution groups, although there was less necrosis than in the control group, the differences were not statistically significant. Hematocrit levels, which initially decreased in conjunction with the hemodilution ratios, returned to normal levels on the 7th day after the operation.
CONCLUSIONS: Our results indicated that 20% or less of the total blood volume loss that may be compensated by the normovolemic hemodilution with dextran can improve flap survival.

Keywords: Blood Transfusion, Hemodilution, Plasma Substitutes, Surgical Flaps, Survival