Effects of clopidogrel and high dose aspirin on survival of skin flaps in rats

Abstract

Clopidogrel is a new antiplatelet agent with a different mechanism of action from aspirin. It is a thienopyridine derivative that is chemically related to ticlopidine, which irreversibly inhibits platelet aggregation by selectively binding to adenylate-cyclase-coupled adenosine diphosphate receptors on the platelet's surface. Aspirin is an antiplatelet agent that acetylates cyclo-oxygenase and decreases the products of arachidonic acid metabolism, including thromboxane and prostacyclin. Necrosis of a flap is still an important complication in reconstructive surgery. To investigate the effects of clopidogrel or high dose aspirin on the survival of skin flaps, 30 rats were divided into three groups of 10 animals each: a control group, a clopidogrel group, and a high-dose aspirin group. No pharmacological agents were used in the control group. Of the two treated groups, the first was given clopidogrel 50 mg/kg/day and the second aspirin 200 mg/kg/day for three days before the operation. After seven days the viable areas of each flap were evaluated and the mean (SD) percentage in the control group was 47 (6), in the clopidogrel group 63 (4), and in the aspirin group 65 (5). Although the mean area of flaps that survived in the aspirin group was slightly higher than in the clopidogrel group, the difference was not significant (p=0.54).

• Clopidogrel
• aspirin
• random flap viability