Effect of Amniotic Membrane Homogenate on Ischemic Skin Flap Survival in Rat Model

Bachground: Surgical skin flaps are frequently used in plastic and reconstructive surgery to repair acquired or congenital defects. Necrosis is a common complication associated with these flaps postoperatively as a result of inadequate blood supply. This study was designed to evaluate the effectiveness of amniotic membrane homogenate in healing the dorsal skin of the rat as an ischemic flap model. Materials and Methods: In this experimental study, twenty male Wistar rats weighing between 350 and 400 g were used in the study. For all rats 3*10 cm, full-thickness, caudally based pattern dorsal skin flaps were elevated. The rats were randomized into 2 groups: control (I) and experimental (II). Then in 10 point,0.1 mL amniotic membrane homogenate was injected with with equal interval in experimental group and normal salin administered in control group. Seven days later all skin flaps were examined mechanically (necrosis) and histologically. Results: Tissue flap necrosis showed significantly reduced in amniotic membrane homogenate group (p=0.032), and tissue flap survival showed significantly increased in amniotic membrane homogenate group (p=0.036). There were no significant differences in the histology analysis heling proccess between two groups (p>0.05). Conclusion: It seems that, the administration of amniotic membrane homogenate is an effective and safe method that improves the survival of ischemic skin flaps in a rat model

Treatment Results of Combined Surgery and Brachytherapy, and the Rate of Recurrence in Patients with Recurrent Keloid Scars

Background: Several options are described to treat keloid scars, none of them being 100% successful. Radiotherapy is suggested to have the most significant effect on recurrence rate. The aim of the study is to evaluate the effectiveness of  High-dose brachytherapy combined with surgery and to evaluate patient satisfaction. Methods and Material: We retrospectively enrolled 5 patients with 10 keloids, treated by surgical excision and high-dose-rate (HDR) brachytherapy. Total dose was 12 Gy in 3 fractions. Results: The median size of the lesions before brachytherapy was 153.48 mm2. The improvement of scars of scoring POSAS by observer and patient were 17.1±3.2 (11-32) and 20.8±11.5 (5-51), respectively. Mean of recurrent time was 26.3±0.9 months. With a median follow-up of 60 months, the overall recurrence-free response rate for all keloids was 20%. Except for one patient, in other patients seen no complications. Conclusion: It seems that keloid excision followed by HDR brachytherapy is effective in the eradication of keloids in treatment. It also resulted in a good cosmetic rate and relief of symptoms. &nbsp