The effect of synovial fluid as a natural source of hyaluronic acid on limberg flap and elliptical rotation flap healing: a comparative study of full-thickness excisional dermal wounds in mice

Abstract

The purpose of this study was to investigate the effi cacy of synovial fl uid (SF) as a source of hyaluronic acid (HA) on Limberg and Elliptical rotation fl ap healing. In this study conducted on 24 male Mus musculus mice, the animals were divided into 2 main groups. Group 1 (n = 12): Limbergfl ap group; Group 2 (n = 12) Elliptical rotation fl ap group. 6 of the animals in Group 1 and Group 2 were assigned as the Flap (Control) Group, and 6 as the Flap + SF Group. In SF subgroups of animals in each group, 1 mL SF was injected into the operation area in addition to the fl ap surgical procedure. The groups were compared in terms of epithelialization, angiogenesis, neutrophil leukocyte infiltration and fibroblast activity, and the eff ect of SF on the infl ammation and wound healing was evaluated. It was observed that epithelization was completed in all animals in the groups which were administered compared to the other groups, and there was a statistically significant diff erence (P<0.05). In addition, no necrosis or abscess was found in the groups which were administered SF. There was no statistical diff erence in the paired comparisons of neutrophil-leukocyte infiltration and fibroblast activity parameters. Although the Limberg fl ap technique is more commonly used today, it can be said that elliptical rotation fl ap is a method that can be used in routine practice due to a lower complication rate. However, SF increases epithelization and plays a regulatory role on angiogenesis. Therefore, it is concluded that the use of SF as a source of HA in combination with elliptical rotation fl ap in wounds with material tissue loss will contribute to clinical practice.

Keywords

• elliptical rotation fl ap
• hyaluronic acid
• limberg fl ap
• synovial fl uid
• experimental study
• wound healing