Comparing the Effect between Oral and Injection Form of Carnitine on Skin Flap Survival in Rats
Paveena Lawanlakkana MD*, Surakarn Saraithong MD**, Chaichoompol Suwantemee MD*, Anont Pitiseree MD*
Affiliation : * Division of Plastic and Reconstructive Surgery, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand ** Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
Background : Carnitine is an endogenous cofactor, having a regulatory action on the energy flow from different oxidative
sources. Carnitine has been used for ischemic conditions such as coronary heart diseases, peripheral vascular diseases with
satisfactory results. So ischemic skin flaps should obtain benefit from carnitine.
Objective : To determine the effect of oral and injection form of carnitine on skin flap survival in a rat model.
Material and Method: Twenty-one Sprague-Dawley rats were divided into 3 groups, each group had 7 rats; a control group
and two carnitine-treated groups. Random skin flap was elevated on the backs of the rats. The control group was not given
any pharmacologic agent. Two treated groups, Group 1 received carnitine orally (150 mg/kg/day) for 3 days before flap
elevation and continuing to 1 week after the procedure, Group 2 received carnitine intraperitoneally (100 mg/kg/day) for 1
week after flap elevation. The surface area of flap survival was measured in each group.
Results : The median areas of flap survival of the control groups and two carnitine treated groups were 65.89%, 69.03%,
77.47%, respectively. There was significant improvement of flaps survival in carnitine-treated groups, especially carnitine
injected group was found to be significantly higher than the control group and carnitine-oral group (p < 0.05). The carnitine-
oral group could slightly increase flap survival compared to the control group but was not statistically significant.
Conclusion : Effect of carnitine has increased flap survival in random skin flap. Carnitine injection form is more effective than
the oral one.
Keywords : Skin flap, Ischemic, Survival
