Preventive effect of botulinum toxin A in microanastomotic thrombosis: A rabbit model

Summary Background Microvascular free tissue transfers play an important role in the reconstruction of body defects. Various aetiologies lead to vascular thrombosis and free-flap failure. In this study, the effects of botulinum toxin A on vessel diameters and prevention of anastomotic thrombosis wer...

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Published in:Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2010-10, Vol.63 (10), p.e720-e724
Main Authors: Fathi, Mehdi, Fathi, Hamidreza, Mazloumi, Mehdi, Khalilzadeh, Omid, Amanpour, Saeid, Meysamie, Alipasha, Mashali, Leila, Kardar, Mohammad H
Format: Article
Language:English
Subjects:
Anastomosis, Surgical
Animals
Botulinum
Botulinum toxin A
Botulinum Toxins, Type A - pharmacology
Disease Models, Animal
Free-flap
Microanastomosis
Plastic Surgery
Postoperative Complications - prevention & control
Rabbit
Rabbits
Random Allocation
Surgical Flaps - blood supply
Thrombosis
Thrombosis - etiology
Thrombosis - prevention & control
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Summary:Summary Background Microvascular free tissue transfers play an important role in the reconstruction of body defects. Various aetiologies lead to vascular thrombosis and free-flap failure. In this study, the effects of botulinum toxin A on vessel diameters and prevention of anastomotic thrombosis were studied in a blinded vasospasm model in rabbits. Methods One side of 16 adult rabbit ears was pre-treated with botulinum toxin type A, and normal saline injections were performed as control in the contralateral side. Seven days later, vessel diameters were measured in both the groups; the vessels were then cut and reanastomosed after vasospastic challenge and vessel patencies were evaluated. Results Both artery and vein diameters were significantly larger in the botulinum toxin A group ( P = 0.002 and < 0.001, respectively). The patency rate of arterial and venous anastomosis was significantly higher in the neurotoxin pre-treated group ( P = 0.038 and 0.003, respectively). Conclusion This study shows that pre-treatment with botulinum toxin type A is associated with a lower rate of arterial and venous thrombosis in rabbit-model microanastomosis. Further studies are necessary to evaluate its ability to decrease vasospasm and thrombosis in free-flap survival of humans.
ISSN:1748-6815
1878-0539
DOI:10.1016/j.bjps.2010.05.030