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.