Investigation of the Effects of Cyclooxygenase I and Cyclooxygenase II Inhibitors on Angiogenesis in a Random-Pattern Rat Abdominal Skin Flap

Abstract

Background:

Cyclooxygenase (COX) inhibiting agents are already in use before, during and after flap surgery due to their analgesic and anti-inflammatory properties and they are known to improve flap viability. We have investigated the influence of selective COX2 inhibitors in the neoangiogenesis of random pattern flaps.

Methods:

Forty-eight rats were divided into 4 groups and their lateral based inguinal flaps measuring 3x3 cm were used as the experimental flap models. Group 1 was the control group so no agents were administered. In groups 2, 3 and 4; Celecoxib (selective COX2 inhibitor), Metamizole Sodium (nonselective COX1 and COX2 inhibitor) and Paracetamol (selective to COX2 in the periphery) were administered, respectively. Clinical observations, radiological studies and histopathological analyses were undertaken in order to demonstrate and compare the individual agents' influence in flap viability and neoangiogenesis.

Results:

Groups 2 and 4 displayed lesser neoangiogenesis when compared with the control group by the end of the first week. The vessel intensities of groups 3 and 1 were not significantly different at the end of the first week; however, by the end of the third week, group 3 yielded a significantly better neoangiogenesis rate (p<0,05). Metamizole sodium is proven to significantly enhance vascularization by the end of 3 weeks.

Conclusion: 

This study has shown that Metamizole Sodium, a collectively inhibiting COX1 and COX2 significantly improves flap vascularity, and when postoperative analgesia is required following a flap surgery, it is a suitable drug of choice.