Efficacy of Topical Nitroglycerin and Transcutaneous Electrical Nerve Stimulation on Survival of Random-Pattern Skin Flaps in Rats

Atalay, Can; Koçkaya, E. Arzu; Çetin, Bahadır; Kısmet, Kemal; Akay, M. Turan

doi:10.1080/alp.37.1.10.13

Cited by 33 publications

(17 citation statements)

References 15 publications

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“…34 Although the majority of animal studies have shown increased flap survival with the use of nitroglycerin ointment, three studies have shown a lack of benefit. 31,35,36 In all of these studies, the dose of nitroglycerin used was low (5 mg), which may be the reason a significant effect was not detected.…”

Section: Discussionmentioning

confidence: 91%

Effects of Nitroglycerin Ointment on Mastectomy Flap Necrosis in Immediate Breast Reconstruction

Gdalevitch

Laeken

Bahng

et al. 2015

Plastic and Reconstructive Surgery

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Section: Discussionmentioning

confidence: 91%

Effects of Nitroglycerin Ointment on Mastectomy Flap Necrosis in Immediate Breast Reconstruction

Gdalevitch

Laeken

Bahng

et al. 2015

Plastic and Reconstructive Surgery

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“…Transcutaneous electrical nerve stimulation (TENS) is primarily used for the alleviation of pain and, in the previous animal and human studies, TENS has been shown to change local blood flow decreasing flap necrosis by activating neural fibers and modifying vascular resistance [1][2][3][4]. Patients treated with various cutaneous and fasciocutaneous flaps were included in the previous studies [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

The effect of transcutaneous electrical nerve stimulation on postmastectomy skin flap necrosis

Atalay

Yılmaz

2009

Breast Cancer Res Treat

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Transcutaneous electrical nerve stimulation (TENS) is primarily used for pain reduction and is thought to activate neural fibers modifying vascular resistance and local blood flow influencing flap necrosis. This study aimed to delineate the effects of TENS on the viability of skin flaps created during mastectomy in breast cancer patients. Patients treated with modified radical mastectomy were prospectively randomized to receive either TENS or no further local treatment postoperatively. High frequency (70 Hz) and low intensity (2 mA) TENS was applied and areas of flap ecchymosis and necrosis were measured after the completion of TENS application and compared between the two groups. Patients were also compared according to age, comorbid diseases, duration of anesthesia, flap area, amount of wound drainage and seroma, presence of wound infection and abscess. In addition, local and systemic complications related to TENS were recorded. About 173 patients with a median age of 49 (range 25-87) were included in the study. About 87 patients received TENS whereas 86 patients formed the control group. Patients' characteristics were comparable between the two groups. Number of patients with skin flap necrosis was higher in the control group compared to TENS group (P < 0.0001). Mean area of flap necrosis was significantly lower in TENS group (85.2 +/- 35.9) compared to control group (252.5 +/- 64.1; P = 0.024). Similarly, number of patients with skin flap ecchymosis was higher in the control group compared to TENS group (P = 0.002). However, although mean area of flap ecchymosis was lower in TENS group (105.5 +/- 49.8) compared to control group (172.9 +/- 49.9), this difference did not reach statistical significance (P = 0.34). In addition, there were no local or systemic complications related to TENS application in patients. TENS can be safely used to decrease the amount of skin flap necrosis after mastectomy in breast cancer patients without any additional complication.

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“…Landecker et al 2 verified that the treatment with retinoic and glycolic acids does not reduce the necrosis area, however, nicotinamide has shown some positive results according to Collins et al 3 Other drugs like nonivamide and nicoboxil, 4 recombinant human erythropoietin, 5 fibroblast growth factor, 6 nitroglycerin, and transcutaneous electrical nerve stimulation 7 have also been investigated, although, in some cases, it remains uncertain if they play a role in the repair of flap injury.…”

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confidence: 97%

Effect of Eletroacupuncture on DU-14 (Dazhui), DU-2 (Yaoshu), and Liv-13 (Zhangmen) on the Survival of Wistar Ratsʼ Dorsal Skin Flaps

Uema¹,

Orlandi²,

Freitas³

et al. 2008

Journal of Burn Care & Research

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The survival of skin flaps has great interest in many areas of Medicine. In practice, one of the most important complications in the use of skin flaps is the tissue ischemia, which frequently results in widespread necrosis and failure of the proposed treatments. The objective of this study was to evaluate the possible benefits of eletroacupuncture stimulation of the points DU-14 (Dazhui), DU-2 (Yaoshu), and Liv-13 (Zhangmen) over the skin flap survival of Wistar rats after 8 days of treatment. Forty male Wistar rats were allocated into four groups with 10 animals each. They were submitted to a surgical procedure in which a dorsal skin flap measuring 10 x 4 cm was elevated and then sutured back with a plastic barrier between the flap and the donor site. During the following 8 days, one group received electro stimulation in two "nonaccupoints" whereas the other one had the accupoints DU-14 (Dazhui), DU-2 (Yaoshu), and Liv-13 (Zhangmen) stimulated. After this period, the rats were killed and flaps were appraised qualitative and quantitatively. Data were evaluated with analysis of variance and to establish significance Fisher's PLSD test was used when analysis of variance showed P < .05. It was observed that electroacupuncture group presented a skin flap survival index remarkably larger than the others. It has also shown a better evolution during the 8 days PO, confirmed by the lowest rate of necrosis and absent area. In this experimental model, eletroacupuncture was an efficient method to preserve vitality and decrease dorsal skin flap necrosis on Wistar rats.

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Efficacy of Topical Nitroglycerin and Transcutaneous Electrical Nerve Stimulation on Survival of Random-Pattern Skin Flaps in Rats

Cited by 33 publications

References 15 publications

Effects of Nitroglycerin Ointment on Mastectomy Flap Necrosis in Immediate Breast Reconstruction

Effects of Nitroglycerin Ointment on Mastectomy Flap Necrosis in Immediate Breast Reconstruction

The effect of transcutaneous electrical nerve stimulation on postmastectomy skin flap necrosis

Effect of Eletroacupuncture on DU-14 (Dazhui), DU-2 (Yaoshu), and Liv-13 (Zhangmen) on the Survival of Wistar Ratsʼ Dorsal Skin Flaps

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