Feasibility of microsurgery in burn injury and the effect of stem cell application

Abstract

Introduction: Burn is one of the most severe traumas and can affect skin, muscle, or bone. Although early debridement and use of skin grafts have proven their benefits; in some cases, free flaps are required for early reconstruction. It is undisputed that choosing recipient vessels from unburned or undamaged zones increase the success of anastomosis. However, it may not be possible, especially in large burns. Our study aims to investigate the success of anastomosis beneath burned tissues and the effects of stem cell application. Materials and Methods: Twenty-one Wistar albino male rats weighing 250 g on average were divided equally into three Groups. In Group I, femoral artery anastomoses were done as control group. Inguinal area of 7 rats was burned as deep 2nd degree depth, and femoral artery anastomoses were done immediately beneath the burned tissues. In Group III, after burning inguinal area and making anastomoses, adipogenic stem cells were applied on the anastomosis sites. All anastomoses were checked at postoperative 3rd day. Results: One rat of Group I died in the postoperative 3rd day and one rat of Group II had a wide wound dehiscence including many of foreign body on anastomosis zone so both were excluded from the study. One anastomosis in Groups I and 3 anastomoses in both Groups II and III failed and others were successful. Statistical analyzes showed that there was no difference between groups (P < 0.05). Stem cell application was not effective on anastomosis patency in burn injury but has benefits in wound healing according to our study. Conclusion: Recipient vessels can be chosen from adjacent area to burn or inflammation zone safely for microvascular anastomosis if there is no direct burn damage on vessels.