Objective: Flaps are used in order to obtain the most favorable functional and esthetic outcomes in the repair of tissue defects in plastic surgery, however flap necrosis continues to be an important problem. Necrosis begins from the distal end in random pattern flaps and is usually caused by inadequate blood flow. In this experimental study, we aimed to increase flap viability by injecting botulinum A to random pattern flaps.

Materials and Methods: Flaps were removed using the caudal base random pattern McFarlan flap model measuring 2x8 cm which was harvested from the dorsum of 18 wistar male rats. The rats were randomly divided to three groups. Group I (control group) was not administered with any drugs, Group II (Botulinum A group) was administered Botulinum-A in the flap 5 days before flap removal and Group III (saline group) was administered saline in the flap 5 days before flap removal. The areas of flap necrosis were calculated for all groups 7 days after flap removal and placement suturing and data were statistically analyzed. The viable and necrotic areas of the flaps in all groups were individually.

Results: The average nectrotic area was 55.91±3.68%, 30.66±3.7% and 58.07±4.05% in Group I, Group II and Group III, respectively. There was no statistically significant difference found between Group I and III in terms of necrosis areas whereas the necrosis area was found to be significantly statistically different in Group II.

Conclusion: Botulinum A toxin injection was found to significantly reduce the area of necrosis.