Comparative evaluation of effect of Trimetazidine and Aspirin on unfavorably raised random skin flaps in rats

Background Various pharmacological agents were used in past to enhance the outcome of failing flaps. This study is done to evaluate the effects of Aspirin & TMZ on unfavorably raised random skin flaps in rats and to compare the most distal part of surviving flap by visual inspection and biopsy. Methods After taking ethical clearance from IAEC, 21 well-grown Sprague-Dawley rats were taken in study. There were three groups, with 7 rats in each group. A Modified McFarlene’s flap (10x3cms) was raised sutured back with 3 − 0 nylon in each group after intraperitoneal administration of 10 mg/kg of TMZ in group II & 40 mg/kg of Aspirin in group III. On POD-5 both objective(Surviving flap area & flap necrosis area) & subjective (color, temperature & turgor) assessment was done along with biopsy at the junction of surviving & necrotic part of the flap. Results The mean surviving flap area was 8.87 cm² in group I, 17.91 cm² in group II and 15.87cm² in group III. The comparison between TMZ and aspirin reveals a mean difference of 2.0 cm², with TMZ showing a slightly higher increase in flap area than aspirin (p < 0.001). The HPE of group I is consistent with ulcerated epithelium with dense inflammation; HPE group II is consistent with unremarkable epithelium with mild fibroblastic proliferation; while HPE of group III is consistent with mild inflammatory pathology with granulation tissue formation. Conclusions Both trimetazidine and aspirin effectively enhance flap survival, with trimetazidine having a marginally greater effect.