Background
Random skin flap is commonly used in plastic and reconstructive surgery, however, distal part of skin flap often occurs ischemia and necrosis. Limonin with bioactivities of pro-inflammation, anti-apoptosis and anti-oxidative stress, may be effective for skin flap survival.
Materials and methods
Random flap model was performed in mice, and animals were divided into the control and limonin groups and treated as follows: the limonin group was injected intraperitoneally with 40 mg/kg limonin for consecutive 7 days, and the control group received an equal volume of vehicle daily. On postoperative day 7, the necrosis skin flaps were observed, while visualization of blood flow below the tissue surface was performed through Laser Doppler blood flow imaging (LDBFI). Then Flap tissues were acquired to assess and levels of angiogenesis, apoptosis and oxidative stress.
Results
Limonin decreased necrosis and edema of skin flaps compared with the control group, with more blood flow in the flap under LDBFI detection. Limonin treatment also increased the mean vessels density, elevated the expression levels of angiogenic proteins (matrix metallopeptidase 9, vascular endothelial growth factor, Cadherin5) and antioxidant proteins (superoxide dismutase 1 (SOD1), endothelial nitric oxide synthase, heme oxygenase), and reduced the expression of apoptotic factors (BAX, CYC, Caspase3).
Conclusion
Limonin enhances survival of random skin flap through induction of angiogenesis, and inhibition of apoptosis and oxidative stress.