Experimental investigation of the effect of thymoquinone on the viability of random patterned skin flaps

OBJECTIVE: The purpose of this study is to demonstrate the potential effects of thymoquinone, a well-known antioxidant agent, on random flap viability and thus to improve the clinical use of these flaps.
METHODS: In this study, 24 Sprague Dawley female albino rats weighing between 200–250 grams were used. Three groups consisting of randomly selected 8 rats were formed, as study, sham and control groups. Modified McFarlane flap model sized 3x9 cm. was used. In control group, only local wound care was carried out for ten days after flap elevation. In sham group, daily intraperitoneal dimethyl sulfoxide (DMSO) solution was injected in the post-operative 10-day period. In the study group thymoquinone and DMSO solution were injected intraperitoneally together. 10 days later, the study was terminated and flaps were photographed for necrotic area measurements, tissue and blood samples were taken out for biochemical and histopathological studies. In biochemical studies, tissue and serum total antioxidant capacity (TAC) and thiobarbituric acid reactive substrates (TBARS) levels were measured. Histopathological studies included inflammatory cell infiltration, collagen, fibroblast formation and angiogenesis.
RESULTS: There was significant decrease in the necrotic areas of flaps in the study group. Serum and tissue antioxidant levels were significantly high and TBARS levels were significantly low. Histopathological examination showed no significant difference in inflammatory cell infiltration, fibroblast formation or angiogenesis between the groups. However, collagen density in the study group was found to be more than the other groups and the structure was better formed.
CONCLUSION: Thymoquinone increases the flap viability due to its antioxidant properties and it has a positive contribution to wound healing, although it has no significant anti-inflammatory or anjiogenetic activity. In the future, we think that it can be clinically useful for preventing distal flap necrosis in patients with high risk.

Random paternli deri fleplerinin yaþayabilirliðinde timokinonun etkisinin deneysel olarak araþtýrýlmasý

Giriþ ve Amaç: Bu deneysel çalýþmanýn amacý antioksidan özelliði bilinen timokinonun random flep yaþayabilirliði üzerine olasý etkilerini göstermek ve bu sayede bu fleplerin klinik kullanýmýný arttýrmaktýr.
Materyal ve Metod: Çalýþmada aðýrlýklarý 200–250 gram arasý deðiþen 24 adet Sprague Dawley cinsi diþi albino sýçan kullanýldý. Kontrol, sham ve deney grubu olmak üzere rastgele seçilmiþ 8’er sýçandan oluþan 3 grup oluþturuldu. Sýçanlarda 3x9 cm.lik modifiye McFarlane flep modeli kullanýldý. Kontrol grubuna flep elevasyonu sonrasý 10 gün boyunca sadece yara bakýmý yapýldý. Sham grubundaki sýçanlara post operatif dönemde 10 gün boyunca intraperitoneal DMSO solüsyonu, deney grubuna 10 gün boyunca intraperioteal timokinon enjekte edildi. 10 gün sonra deney sonlandýrýlarak fleplerde alan ölçümü için fotoðraflama, biyokimyasal inceleme için serum ve doku, histopatolojik inceleme için doku örnekleri alýndý. Fleplerde nekroz alanlarý, inflamatuar hücre, kollajen, fibroblast yoðunluðu, anjiogenez, serum ve doku total antioksidan kapasite ve tiyobarbitürik asit reaktif maddelerinin düzey ölçümleri yapýldý.
Bulgular: Deney grubunda nekroz alanlarýnda diðer gruplara göre anlamlý derecede azalma tespit edildi. Biyokimyasal incelemelerde serum ve doku örneklerinde total antioksidan kapasitede anlamlý artýþ ve tiyobarbitürik asit reaktif maddelerinde anlamlý azalma tespit edildi. Histopatolojik incelemelerde inflamatuar hücre düzeyinde, firoblast oluþumunda, anjiogenezde gruplar arasýnda anlamlý fark gözlenmedi. Deney grubunda kollajen yoðunluðu daha fazla ve kollajen yapýsýnýn daha düzenli olduðu görüldü.
Sonuç: Timokinonun antioksidan etkinlik göstererek flep yaþayabilirliðini arttýrdýðý ve anlamlý antiinflamatuar, anjiogenetik etki göstermemekle birlikte yara iyileþmesine olumlu katký saðladýðý çalýþmamýzda gösterilmiþtir. Timokinonun gelecekte klinikte yükse riskli vakalarda distal flep nekrozunu azaltma amaçlý kullanýlabileceðini düþünmekteyiz. (NCI-2024-6-6)