BackgroundRandom-pattern flap transfer is commonly used to treat soft-tissue defects. However, flap necrosis remains a serious problem. Naringin accelerates angiogenesis by activating the expression of vascular endothelial growth factor (VEGF). In the present study, we investigated whether naringin improves the survival of random skin flaps.ResultsCompared with controls, the naringin-treated groups exhibited significantly larger mean areas of flap survival, significantly increased SOD activity and VEGF expression, and significantly reduced MDA level. Hematoxylin and eosin (HE) staining revealed that naringin promoted angiogenesis and inhibited inflammation.Materials and Methods“McFarlane flap” models were established in 90 male Sprague-Dawley (SD) rats divided into three groups: a 40 mg/kg control group (0.5 % sodium carboxymethylcellulose), a 40 mg/kg naringin-treated group, and an 80 mg/kg naringin-treated group. The extent of necrosis was measured 7 days later, and tissue samples were subjected to histological analysis. Angiogenesis was evaluated via lead oxide–gelatin angiography, immunohistochemistry, and laser Doppler imaging. Inflammation was evaluated by measurement of serum TNF-α (tumor necrosis factor-α) and IL-6 (interleukin-6) levels. Oxidative stress was assessed by measuring superoxide dismutase (SOD) activity and the malondialdehyde (MDA) level.ConclusionNaringin improved random skin flap survival.

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BackgroundReconstruction of chronic lower extremity wounds remains challenging. These wounds are mainly associated with diabetes mellitus, infections, and osteomyelitis. Although several reconstructive techniques are available, the peroneal artery perforator flap has unique advantages.MethodsIn this study, we discuss our experiences with peroneal artery perforator flaps in 55 patients who had suffered from chronic lower limb wounds. The size of the defect, comorbidities, etiology, flap size, and complications were recorded and analyzed based on a retrospective chart review.ResultsAll 55 flaps survived. In two cases, small superficial necrosis occurred, one of which healed with conservative treatment and the other was reconstructed with split thickness skin grafts. Partial necrosis was observed in nine cases, seven of which were covered with split thickness skin grafts and the remaining two sutured directly after adequate debridement. Vascular compromise was observed in one patient, which was salvaged successfully by performing an exploratory procedure and releasing a few sutures. No complications were seen in the remaining 44 cases.ConclusionThe peroneal artery perforator flap is a reliable option for reconstruction of chronic lower extremity wounds.

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