Comparison of the efficacy of multiple antioxidant and hyperbaric oxygen treatments in the prevention of ischemia and necrosis of local random McFarlane skin flap

Doğan, Remzi; Güler, Eray Metin; Koçyiğit, Abdürrahim; Bayındır, Nihan; Eşrefoğlu, Mukaddes; Mirasoglu, Bengisu Oroglu; Yenigün, Alper; Özturan, Orhan

doi:10.1016/j.jtv.2021.02.008

Cited by 8 publications

(5 citation statements)

References 61 publications

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“…Wang et al (2020) reported loss of tissue microarchitecture and disorganized dermal/epidermal layer after 7 days of ischemia in a skin flap avulsion model. After 14 days of flap elevation, Dogan et al (2021) observed absence of hair and sebaceous glands with degenerated epithelium in the distal tip (Figure 3).…”

Section: Resultsmentioning

confidence: 98%

“…H&E assessment was the most used histological assessment of ischemic injury and IRI in this systematic review. Structural changes including hair follicular and sebaceous gland atrophy, epithelial degeneration, and collagen necrosis are late findings typically not seen before 3 days, but evident at 14 days (Dogan et al, 2021; Tsai et al, 2015). Neovascularization and vessel density are also late findings (5–14 days), with decreased vessel density in IRI compared to ischemia (Fan et al, 2021; Park et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…After 14 days of flap elevation, Dogan et al (2021) observed absence of hair and sebaceous glands with degenerated epithelium in the distal tip (Figure 3).…”

Section: Prolonged Ischemia and Iri Lead To Tissue Edema And Epiderma...mentioning

confidence: 97%

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Systematic review of pathologic markers in skin ischemia with and without reperfusion injury in microsurgical reconstruction: Biomarker alterations precede histological structure changes

Khalaf,

Duarte Bateman,

Reyes

et al. 2024

Microsurgery

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BackgroundIschemia and ischemia–reperfusion injury contribute to partial or complete flap necrosis. Traditionally, skin histology has been used to evaluate morphological and structural changes, however histology does not detect early changes. We hypothesize that morphological and structural skin changes in response to ischemia and IRI occur late, and modification of gene and protein expression are the earliest changes in ischemia and IRI.MethodsA systematic review was performed in accordance with PRISMA guidelines. Studies reporting skin histology or gene/protein expression changes following ischemia with or without reperfusion injury published between 2002 and 2022 were included. The primary outcomes were descriptive and semi‐quantitative histological structural changes, leukocyte infiltration, edema, vessel density; secondary outcomes were quantitative gene and protein expression intensity (PCR and western blot). Model type, experimental intervention, ischemia method and duration, reperfusion duration, biopsy location and time point were collected.ResultsOne hundred and one articles were included. Hematoxylin and eosin (H&E) showed inflammatory infiltration in early responses (12–24 h), with structural modifications (3–14 days) and neovascularization (5–14 days) as delayed responses. Immunohistochemistry (IHC) identified angiogenesis (CD31, CD34), apoptosis (TUNEL, caspase‐3, Bax/Bcl‐2), and protein localization (NF‐κB). Gene (PCR) and protein expression (western blot) detected inflammation and apoptosis; endoplasmic reticulum stress/oxidative stress and hypoxia; and neovascularization. The most common markers were TNF‐α, IL‐6 and IL‐1β (inflammation), caspase‐3 (apoptosis), VEGF (neovascularization), and HIF‐1α (hypoxia).ConclusionThere is no consensus or standard for reporting skin injury during ischemia and IRI. H&E histology is most frequently performed but is primarily descriptive and lacks sensitivity for early skin injury. Immunohistochemistry and gene/protein expression reveal immediate and quantitative cellular responses to skin ischemia and IRI. Future research is needed towards a universally‐accepted skin injury scoring system.

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Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Systematic review of pathologic markers in skin ischemia with and without reperfusion injury in microsurgical reconstruction: Biomarker alterations precede histological structure changes

Khalaf,

Duarte Bateman,

Reyes

et al. 2024

Microsurgery

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“…10,14,41,42 The effects of zinc on fat graft survival are currently unknown, as studies have focused on its effects on flap viability. 43…”

Section: Discussionmentioning

confidence: 99%

“…10,14,41,42 The effects of zinc on fat graft survival are currently unknown, as studies have focused on its effects on flap viability. 43 Although previous studies have demonstrated similar benefits of substances with antioxidant properties on fat graft viability, the results are not easily comparable because of differences in dosages, routes of administration, and types of animals used. The closest study with a similar methodology that includes the materials we used in our study was conducted by Dang et al 20 In their study, melatonin was applied at different doses, and it was determined that the survival rate of fat graft with medium-and low-dose (20 and 10 mg/kg) melatonin (41.7 ± 3.42%) was higher compared with the control group (26.3 ± 4.18%).…”

Section: Plastic and Reconstructive Surgery • June 2024mentioning

confidence: 99%

Increased Total Antioxidant Capacity Value Improves Survival of Fat Grafts in Rat Model

Cinar

Yalcin

Ayas

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: While studies aiming to increase fat graft survival continue, in this study, we aimed to investigate the effects of different antioxidants on total antioxidant capacity and their effect on graft survival. Methods: Thirty-two male Wistar rats were divided into four equally sized groups, including a control group and three antioxidant groups receiving either Melatonin (10mg/kg), Zinc (2mg/kg), or Vitamin E and C (100mg/kg). Autologous fat grafts (1.7± 0.4gr) were transferred to the dorsal subcutaneous region, and total antioxidant capacity was measured on day 0 and 1, week 1 and monthly until the third month. Transferred graft volume and mass (1.3± 0.4gr) were measured using the liquid overflow method and precision scales at the end of the study. Routine hematoxylin-eosin staining and immunohistochemistry against perilipin were performed for semiqualitative analysis and h-score for viable adipose cells, respectively. Results: Collected fat grafts measured significantly less in weight and volume and the survival rate was lower in the control group (p<0.01). Control group exhibited a reduction in TAC, while all groups receiving antioxidants had an increase in TAC during the first week (p=0.02, 0.008, and 0.004 for melatonin, zinc, and vitamins, respectively). Immunohistochemistry of the antioxidant group demonstrated a statistically significant excess and reactivity of cells staining with perilipin antibodies. Conclusions: In this animal study, the beneficial effect of antioxidants on fat graft survival can be related to the significant increase in TAC following the first week of their administration.

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The effect of pitavastatin in an ischemic skin flap model in rats

Yuste Benavente,

Trigo Cebrian,

Gonzalez Pastor

et al. 2024

Eur J Plast Surg

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Comparison of the efficacy of multiple antioxidant and hyperbaric oxygen treatments in the prevention of ischemia and necrosis of local random McFarlane skin flap

Cited by 8 publications

References 61 publications

Systematic review of pathologic markers in skin ischemia with and without reperfusion injury in microsurgical reconstruction: Biomarker alterations precede histological structure changes

Systematic review of pathologic markers in skin ischemia with and without reperfusion injury in microsurgical reconstruction: Biomarker alterations precede histological structure changes

Increased Total Antioxidant Capacity Value Improves Survival of Fat Grafts in Rat Model

The effect of pitavastatin in an ischemic skin flap model in rats

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