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 carnitineoral 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