Effects of hyperbaric oxygen and N-acetylcysteine in survival of random pattern skin flaps in rats

ABSTRACT Objective: Our aim is to investigate the role of HBO (hyperbaric oxygen), NAC (N-acetylcysteine), and HBO plus NAC on the necrosis area of random rat′s skin flaps of a modified McFarlane flap design. Materials and Methods: Thirty-two male Wistar rats were randomly divided into four groups: G-S (sham: n = 8), G-NAC (NAC: n = 8), G-HBO (HBO: n = 8), and G-HN (HBO plus NAC: n = 8). A rectangular skin flap (2 × 8 cm 2 ) was dissected from the muscular dorsal layer, preserving the cranial pedicle. Polyethylene film was placed over the muscular layer and an interrupted 3.0 nylon suture was employed to fix the flap into the original place. On the eighth day, full-thickness biopsy samples (2 × 1 cm 2 ) were collected from the proximal, middle, and cranial areas of the skin flap, and in a site away from the flap labelled as the control area. Results: The measurements of necrotic areas in the groups were 18.3% in G-S, 24.3% in G-NAC, 12.6% in G-HBO, and 14.9% in G-HN. Significant difference was observed between the groups G-HBO and G-HN as well as G-NAC. Conclusion: HBO is associated with reduced area of necrosis of skin flap. The G-NAC group was associated with poor results when examined in isolation. The association between HBO and NAC did not produce favourable results with respect to the use of HBO alone. These findings suggest that the diffusion of oxygen through the interstitial space was the determining factor of more favourable results of HBO.

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The Relationship of Hematocrit Levels to Skin Flap Survival Length in the Pig

Otolaryngology ◽

10.1177/019459988108900511 ◽

1981 ◽

Vol 89 (5) ◽

pp. 750-752 ◽

Cited By ~ 5

Author(s):

Jeffrey B. Alperstein ◽

Howard L. Levine ◽

Harvey M. Tucker

Keyword(s):

Human Skin ◽

Control Animal ◽

Skin Flap ◽

Random Pattern ◽

Skin Flaps ◽

Flap Survival ◽

Significant Difference ◽

Skin Flap Survival ◽

Relationship Of ◽

The Relationship

The work of several investigators suggests that anemia may increase the survival length of skin flaps in the dog and the rabbit. The following experiment was designed to study the survival of standardized skin flaps of varying lengths in normocythemic, polycythemic, and anemic pigs. The pig was chosen because of the similarity of its skin to that of human skin. Twenty-nine standardized random-pattern flaps and six standardized arterial flaps were studied in pigs with varying hematocrits. A statistically significant increase was found in the survival lengths of skin flaps in the polycythemic animal as compared with the anemic one. No significant difference was found when the flap survival lengths of the normocythemic control animal were compared with those of the polycythemic animal or with those of the anemic animal. These findings suggest that relative polycythemia may allow improved flap length-survival and, in contradistinction to the findings of previous investigators, that anemia does not result in improved survival length.

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The Role of Photoplethysmography in the Prediction of the Experimental Flap Survival

Otolaryngology ◽

10.1177/019459987808600322 ◽

1978 ◽

Vol 86 (3) ◽

pp. ORL-492-ORL-497 ◽

Cited By ~ 2

Author(s):

Janusz Bardach ◽

Richard J. Voots ◽

Brian F. McCabe ◽

Mow Ming Hsu

Keyword(s):

Skin Flap ◽

Skin Flaps ◽

Arterial Blood ◽

Flap Viability ◽

Significant Difference ◽

Blood Density ◽

Density Scale ◽

Experimental Flap ◽

Venous Vasculature

A standard photoplethysmograph, modified to differentiate between arterial and venous vasculature in skin tissue, has been used to measure arterial supply in 100 unipedicle skin flaps in 25 pigs. A datum transform from a light intensity scale to a relative arterial blood density scale has been introduced and empirically labeled the vascular coefficient (VC). Statistical analysis of the VC data shows a significant difference between necrotic and surviving flap group mean data as early as 24 hours. Additional analysis in which a normal ogive was fitted to the sample VC data distributions suggests that statistically significant predictions of the probability of eventual flap necrosis can be made using VC measurements obtained immediately postoperatively. It is concluded that the modified photoplethysmograph, in conjunction with the VC data transform, constitutes a usable measuring technique for skin flap viability prediction in the experimental animal.

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A Model for Training in Elevation of Local Skin Flaps in the Hand

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681(94)90261-5 ◽

1994 ◽

Vol 19 (6) ◽

pp. 794-795 ◽

Cited By ~ 3

Author(s):

H. D. SKOFF

Keyword(s):

Skin Flap ◽

Three Dimensional ◽

Skin Flaps ◽

Dimensional Model ◽

Surgical Experience ◽

Three Dimensional Model ◽

Local Skin ◽

Practice Models ◽

Flap Design

Appropriate skin flap design is crucial for success in surgery of the hand. Practice models are useful in acquiring surgical experience. The author describes a three-dimensional model composed of readily available materials which has been useful for practice in elevation of local skin flaps in the hand

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Evaluation of platelet-rich plasma gel as an angiogenesis-inducing agent in canineadvancement skin flaps

Pesquisa Veterinária Brasileira ◽

10.1590/1678-5150-pvb-6512 ◽

2020 ◽

Vol 40 (6) ◽

pp. 474-478

Author(s):

Grazielle A.S. Aleixo ◽

Maria C.O.C. Coelho ◽

Telga L.A. Almeida ◽

Márcia F. Pereira ◽

Miriam N. Teixeira ◽

...

Keyword(s):

Blood Vessel ◽

Skin Color ◽

Platelet Rich Plasma ◽

Skin Flap ◽

Skin Flaps ◽

Experimental Conditions ◽

Significant Difference ◽

Experimental Group ◽

Prp Gel ◽

Made In

ABSTRACT: This work aimed to evaluate the effect of platelet-rich plasma (PRP) on advancement skin flaps in dogs regarding improvement of vascularization, with focus on increasing its viable area, since there are reports that it is a potential angiogenesis stimulator. The experimental group was composed of eight adult bitches, in which two advancement skin flaps were made in the ventral abdominal region. No product was applied in the control flap (CF), while PRP was used in the contralateral flap, called treated flap (TF). The areas were clinically evaluated every two days until the 7th postoperative day regarding skin color and presence of necrosis. At 10 days, both flaps were removed and submitted to histological examination and blood vessel morphometry. The vessels counted in each group were statistically analyzed by the F-test at 1% probability. Results showed no significant difference in macroscopic changes in the wound, or CF and TF vascularization, thus suggesting that PRP gel did not improve advancement skin flap angiogenesis in bitches under the experimental conditions in which this research was developed.

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Effect of Free-Radical Scavengers and Hyperbaric Oxygen on Random-Pattern Skin Flaps

Archives of Surgery ◽

10.1001/archsurg.1994.01420330096017 ◽

1994 ◽

Vol 129 (9) ◽

pp. 982 ◽

Cited By ~ 22

Author(s):

Richard J. Stewart

Keyword(s):

Free Radical ◽

Hyperbaric Oxygen ◽

Free Radical Scavengers ◽

Random Pattern ◽

Skin Flaps ◽

Radical Scavengers

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FGF21 augments autophagy in random-pattern skin flaps via AMPK signaling pathways and improves tissue survival

Cell Death and Disease ◽

10.1038/s41419-019-2105-0 ◽

2019 ◽

Vol 10 (12) ◽

Cited By ~ 2

Author(s):

Kailiang Zhou ◽

Huanwen Chen ◽

Jinti Lin ◽

Hui Xu ◽

Hongqiang Wu ◽

...

Keyword(s):

Signaling Pathways ◽

Nuclear Translocation ◽

Skin Flap ◽

Therapeutic Benefit ◽

Random Pattern ◽

Skin Flaps ◽

Flap Survival ◽

Ampk Signaling ◽

Flap Viability ◽

Mechanistic Investigation

AbstractRandom-pattern skin flap is commonly used for surgical tissue reconstruction due to its ease and lack of axial vascular limitation. However, ischemic necrosis is a common complication, especially in distal parts of skin flaps. Previous studies have shown that FGF21 can promote angiogenesis and protect against ischemic cardiovascular disease, but little is known about the effect of FGF21 on flap survival. In this study, using a rat model of random skin flaps, we found that the expression of FGF21 is significantly increased after establishment skin flaps, suggesting that FGF21 may exert a pivotal effect on flap survival. We conducted experiments to elucidate the role of FGF21 in this model. Our results showed that FGF21 directly increased the survival area of skin flaps, blood flow intensity, and mean blood vessel density through enhancing angiogenesis, inhibiting apoptosis, and reducing oxidative stress. Our studies also revealed that FGF21 administration leads to an upregulation of autophagy, and the beneficial effects of FGF21 were reversed by 3-methyladenine (3MA), which is a well-known inhibitor of autophagy, suggesting that autophagy plays a central role in FGF21’s therapeutic benefit on skin flap survival. In our mechanistic investigation, we found that FGF21-induced autophagy enhancement is mediated by the dephosphorylation and nuclear translocation of TFEB; this effect was due to activation of AMPK-FoxO3a-SPK2-CARM1 and AMPK-mTOR signaling pathways. Together, our data provides novel evidence that FGF21 is a potent modulator of autophagy capable of significantly increasing random skin flap viability, and thus may serve as a promising therapy for clinical use.

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Protective effect of modafinil on skin flap survival in the experimental random-pattern skin flap model in rats: The role of ATP-sensitive potassium channels and nitric oxide pathway

Journal of Plastic Reconstructive & Aesthetic Surgery ◽

10.1016/j.bjps.2020.10.084 ◽

2020 ◽

Author(s):

Armin Aryannejad ◽

Ali Gandominejad ◽

Mohammadreza Tabary ◽

Nafise Noroozi ◽

Ata Abbasi ◽

...

Keyword(s):

Nitric Oxide ◽

Potassium Channels ◽

Protective Effect ◽

Skin Flap ◽

Random Pattern ◽

Flap Survival ◽

Skin Flap Survival ◽

Nitric Oxide Pathway

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The effect of hyperbaric oxygen therapy on the survival of random pattern skin flaps in nicotine-treated rats

Yearbook of Plastic and Aesthetic Surgery ◽

10.1016/j.yprs.2012.07.004 ◽

2013 ◽

Vol 2013 ◽

pp. 175-177

Author(s):

J. Boehmler

Keyword(s):

Hyperbaric Oxygen ◽

Hyperbaric Oxygen Therapy ◽

Oxygen Therapy ◽

Random Pattern ◽

Skin Flaps

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The effect of transcutaneous electrical nerve stimulation on the viability of random skin flaps in rats

Canadian Journal of Plastic Surgery ◽

10.1177/229255030201000407 ◽

2002 ◽

Vol 10 (4) ◽

pp. 151-154 ◽

Cited By ~ 19

Author(s):

Richard Eloin Liebano ◽

Lydia Masako Ferreira ◽

Miguel Sabino Neto

Keyword(s):

Nerve Stimulation ◽

Transcutaneous Electrical Nerve Stimulation ◽

Skin Flap ◽

Control Group ◽

Skin Flaps ◽

Electrical Nerve Stimulation ◽

Flap Viability ◽

Group 2 ◽

Group 1

The aim of this study was to determine the role of transcutaneous electrical nerve stimulation (TENS) in the viability of random skin flaps. In 30 Wistar-EPM rats, a random 10×4 cm skin flap was raised and a plastic barrier was interposed between the flap and its bed. Immediately after surgery and for two subsequent days, the rats in group 1 (the control group) were anesthetized for 1 h with the electrodes positioned in the base of the flap and without the administration of the electric stimulus. The rats in group 2 (the treatment group) were submitted to TENS for 1 h immediately after the surgery and for two subsequent days. The percentage of necrotic area (averages of 43.11% in the rats in group 1 and 23.52% in the rats in group 2) was calculated on the seventh postoperative day in both groups. Statistical analysis proved that TENS was more efficient in increasing random skin flap viability than was the method used in the control group.

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