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Neutrophil Elastase Inhibitor Increases Flap Survival in Experimental Degloving Injuries.
Sisli Etfal Hastan Tip Bul. 2020; 54(2):169-175.SE

Abstract

Objectives

Degloving hand injuries have generally been viewed as among the most difficult of injuries to manage due to the extensive nature of associated damage. The traditional approach to the circumferentially degloved segment of problematic flap viability has been to resuture the flap and to wait and see. However, the waiting period or the specific hemorheological protocol remains uncertain. This study aims to acknowledge if Sivelestat, known to ameliorate ischemia-reperfusion injury, enhances the survival of avulsed flaps in a hind limb degloving model of rats and to compare Sivelestat's effects to Pentoxifylline.

Methods

In this study, total flap area (cm2), area of necrosis in the flap (cm2), and the ratio between the necrotic and total areas (percentage) were determined. Angiogenesis among the groups was documented with CD31, anti-PECAM staining. TUNEL assay was performed to allow the visualization of cell nuclei containing fragmented DNA, a typical feature of apoptosis.

Results

The findings obtained in this study showed that Sivelestat administered at 10 mg/kg/hour dosage will inhibit the ischemia-reperfusion injury more pertinently than Pentoxifylline, which exerts only hemorheological effects.

Conclusion

The anti-inflammatory effects of Sivelestat will be beneficial for decreasing the early complications of degloving injury, such as inflammation, sepsis, and edema, better than Pentoxifylline, which exerts only hemorheological effects.

Authors+Show Affiliations

Department of Plastic Reconstructive and Aesthetic Surgery, Kirikkale Yuksek Ihtisas Hospital, Kirikkale, Turkey.Department of Plastic Reconstructive and Aesthetic Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.MVK Aesthetic Clinic, Istanbul, Turkey.Department of Plastic Reconstructive and Aesthetic Surgery, Bezmialem Foundation University, Istanbul, Turkey.Department of Plastic Reconstructive and Aesthetic Surgery, Trakya University Faculty of Medicine, Edirne, Turkey.Department of Plastic Reconstructive and Aesthetic Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.Department of Plastic Reconstructive and Aesthetic Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.Department of Plastic Reconstructive and Aesthetic Surgery, Bezmialem Foundation University, Istanbul, Turkey.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32617053

Citation

Yuce, Erkan, et al. "Neutrophil Elastase Inhibitor Increases Flap Survival in Experimental Degloving Injuries." Sisli Etfal Hastanesi Tip Bulteni, vol. 54, no. 2, 2020, pp. 169-175.
Yuce E, Sevim KZ, Kiyak MV, et al. Neutrophil Elastase Inhibitor Increases Flap Survival in Experimental Degloving Injuries. Sisli Etfal Hastan Tip Bul. 2020;54(2):169-175.
Yuce, E., Sevim, K. Z., Kiyak, M. V., Yildiz, K., Dagdelen, D., Irmak, F., Karsidag, S., & Kilic, U. (2020). Neutrophil Elastase Inhibitor Increases Flap Survival in Experimental Degloving Injuries. Sisli Etfal Hastanesi Tip Bulteni, 54(2), 169-175. https://doi.org/10.14744/SEMB.2018.45077
Yuce E, et al. Neutrophil Elastase Inhibitor Increases Flap Survival in Experimental Degloving Injuries. Sisli Etfal Hastan Tip Bul. 2020;54(2):169-175. PubMed PMID: 32617053.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neutrophil Elastase Inhibitor Increases Flap Survival in Experimental Degloving Injuries. AU - Yuce,Erkan, AU - Sevim,Kamuran Zeynep, AU - Kiyak,Medeni Volkan, AU - Yildiz,Kemalettin, AU - Dagdelen,Daghan, AU - Irmak,Fatih, AU - Karsidag,Semra, AU - Kilic,Ulkan, Y1 - 2018/07/25/ PY - 2018/07/19/received PY - 2018/07/24/accepted PY - 2020/7/4/entrez PY - 2018/7/25/pubmed PY - 2018/7/25/medline KW - Degloving injury KW - ischemia reperfusion injury KW - neutrophil elastase inhibitor SP - 169 EP - 175 JF - Sisli Etfal Hastanesi tip bulteni JO - Sisli Etfal Hastan Tip Bul VL - 54 IS - 2 N2 - Objectives: Degloving hand injuries have generally been viewed as among the most difficult of injuries to manage due to the extensive nature of associated damage. The traditional approach to the circumferentially degloved segment of problematic flap viability has been to resuture the flap and to wait and see. However, the waiting period or the specific hemorheological protocol remains uncertain. This study aims to acknowledge if Sivelestat, known to ameliorate ischemia-reperfusion injury, enhances the survival of avulsed flaps in a hind limb degloving model of rats and to compare Sivelestat's effects to Pentoxifylline. Methods: In this study, total flap area (cm2), area of necrosis in the flap (cm2), and the ratio between the necrotic and total areas (percentage) were determined. Angiogenesis among the groups was documented with CD31, anti-PECAM staining. TUNEL assay was performed to allow the visualization of cell nuclei containing fragmented DNA, a typical feature of apoptosis. Results: The findings obtained in this study showed that Sivelestat administered at 10 mg/kg/hour dosage will inhibit the ischemia-reperfusion injury more pertinently than Pentoxifylline, which exerts only hemorheological effects. Conclusion: The anti-inflammatory effects of Sivelestat will be beneficial for decreasing the early complications of degloving injury, such as inflammation, sepsis, and edema, better than Pentoxifylline, which exerts only hemorheological effects. SN - 1302-7123 UR - https://www.unboundmedicine.com/medline/citation/32617053/Neutrophil_Elastase_Inhibitor_Increases_Flap_Survival_in_Experimental_Degloving_Injuries L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32617053/ DB - PRIME DP - Unbound Medicine ER -
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