Effect Of Nebivolol On Rat Tram Flap Viability

Breast reconstruction is an essential part of the breast cancer threapy. The transverse rectus abdominis musculocutaneous (TRAM) flap has been widely used for reconstruction of the breast. Partial loss of the flap is still a major problem. The defficiency of flap perfusion may cause partial necrosis of the flap. Periferic vasodilatation may increases flap viability. The aim of this study is evaluation of affect of nebivolol on rat TRAM flap perfusion. Nebivolol is a selective β1 adrenergic receptor antagonist that causes a direct vasodilator effect attributed to the action on vascular nitric oxide (NO). In this study 30 male spraque–dawley rats were used. A pedicled TRAM flap based upon the the right inferior epigastric artery was elevated and reapproximated. Animals were randomly assigned to 5 treatment groups (n:6). Group 1 received no nebivolol. Groups 2 through 5 were administered 100 mg/kg nebivolol orally 24 hours preoperatif; in addition groups 2 to 4 received orally postoperatif for 7 days. Group 3 also received intraoperatively; groups 4 and 5 were given nebivolol orally for 7 days before the 24 hours preoperatif treatment. Seven days after surgery skin paddles were photographed and assessed for viability. In seventh day blood lactate levels were measured. Statically significant differences were found in all experimental groups relative to the controls. Group 4 displayed the greatest improvement in flap viability, significantly better than other nebivolol groups. This study indicates that nebivolol may provide a useful pharmacologic tool for reducing iscemia-reletad necrosis in TRAM flaps.