Hyaluronic acid dermal filler injection increases the survival of rat dorsal skin flaps

Background Distal tip necrosis of random pattern skin flaps is the most occurring complication in skin flap surgery. Delay phenomenon augments flap vascularity and increases survival of skin flaps. In this study, hyaluronic acid dermal filler was used in the rat dorsal skin via subcutaneous injection to reveal its role in the flap viability and the delay phenomenon. Methods Eighteen rats were randomized in 3 groups. Group 1 rats were the control group. Group 2 rats underwent surgical delay procedure. Group 3 was pretreated with 1 mL of hyaluronic acid dermal filler injection. Seven days after, a caudally based dorsal skin flap was elevated. Flap necrosis area, intensity of the newly formed vessels, subdermal vascular architecture, and inflammation severity in the flaps were evaluated. Results Flap necrosis areas were found statistically significant among the groups. The mean number of subdermal capillaries increased significantly in group 3. The mean values of vessel diametres were statistically significant among the groups. Inflammation scores of groups 2 and 3 were low or moderate levels. Conclusions HA injection increases the survival of rat dorsal flaps; however, it is not superior or equivalent to surgical delay at least with this volume, concentration, and delay time.