가토의 확장피판에 Epinephrine의 국소주입이 피판의 생존면적에 미치는 영향

Abstract

[한글]

조직확장기를 사용하여 얻은 확장피판의 여러 특성은 지연피판술과 흡사함을 보여주고 있다. 그런데, 피판의 지연술시에는 epinephrine 주입시 피판의 손실이 증가되므로 epinephrine 주입이 금기로 되어 있다. 본 연구에서는epinephrine과 생리식염수 혼합액(1 : 100,000) 국소주입시 지연피판과 흡사한 특성을 지니고 있는 확장된 피판의 생존면적에 대한 영향을 알아보고자 하였다. 실험동물로는 실험에 성공한 9마리의 New Zealand 흰토끼를 사용하였고, 실험은 2군으로 분류하여 실험군은 조직확장 2주 후 좌측배부에 epinephrine과 생리식염수 혼합액(1 : 100,000) 국소주입 후 2X7cm의 피판을 거상한 군으로 피판거상 7일 후에 피판의 괴사면적을 산출하였으며 대조군은 같은 방법으로 피판을 거상하되 epinephrine 대신 생리식염수만을 국소 주입하였다. 실험결과 실험군 (평균괴사율 74.52%)은 대조군 (평균괴사율 33,78%)에 비하여 통계학적으로 의의있는 차이로 괴사가 심함을 알 수 있었다. 확장피판에서는 epinephrine 사용시 감수성 항진현상이 나타나므로 피판의 손실이 증가될 수 있다. 그러므로 출혈이 즘 더 많고 마취시간이 지연된다 하더라도 확장피판에서는 epinephrine을 사용하지 않는 것이 바람직하다.

Effect of the mixture of saline and epinephrine on the survival of expanded flaps

in rabbit

Song Woo Kim

Department of Medical Science,The Graduate School, Yonsei University

(Directed by Professor Beyoung Yun Park)

There has been some similarities between the expanded flaps and delayed flaps. In

delayed flaps, mixture of saline and epinephrine injection has been forbidden due

to increased flap loss. In this experiment, the effect of mixture of normal saline

and epinephrine on the survival of expanded flaps, was evaluated by comparison

between experimental and control group using 9 New Zealand rabbits. In experimental

group, the 2X7cm sized flaps injected with mixture of saline and 1 : 100,000

epinephrine were elevated from the left back of rabbits after 2 weeks of expansion.

A week later, the necrotic areas of flaps in experimental group were calculated and

compared with those of comparison group, in which normal saline was injected

instead of mixture of epinephrine and normal saline. In conclusion, necrotic areas

of epinephrine injection group were far broader than those of normal saline group.

So in expanded flaps, injection of epinephrine might increase flap loss. In spite

of much bleeding and short anesthetic effect, local epirephrine injection should

not be recommended in expanded flaps.

[영문]

There has been some similarities between the expanded flaps and delayed flaps. In delayed flaps, mixture of saline and epinephrine injection has been forbidden due to increased flap loss. In this experiment, the effect of mixture of normal saline

and epinephrine on the survival of expanded flaps, was evaluated by comparison between experimental and control group using 9 New Zealand rabbits. In experimental group, the 2X7cm sized flaps injected with mixture of saline and 1 : 100,000 epinephrine were elevated from the left back of rabbits after 2 weeks of expansion.

A week later, the necrotic areas of flaps in experimental group were calculated and compared with those of comparison group, in which normal saline was injected instead of mixture of epinephrine and normal saline. In conclusion, necrotic areas

of epinephrine injection group were far broader than those of normal saline group.

So in expanded flaps, injection of epinephrine might increase flap loss. In spite of much bleeding and short anesthetic effect, local epirephrine injection should not be recommended in expanded flaps.