Prevention of unfavourable effects of cigarette smoke on flap viability using botulinum toxin in random pattern flaps: An experimental study

Karayel, Hikmet; Kaya, Burak; Çaydere, Muzaffer; Terzioğlu, Ahmet; Aslan, Gürcan

doi:10.1177/229255031502300309

Cited by 13 publications

(8 citation statements)

References 64 publications

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“…1,6-8, 10, 22, 32, 36, 39, 40, 49, 50, 54, 57,62 In these studies, a rat model was most commonly used (n = 14/15) and there was significant variability in BTX dose (0.1-20 IU), application method (subdermal, intradermal, subcutaneous, intramuscular or perivascular injection, direct application to the vessels, or tissue bath), treated flaps (random cutaneous, abdominal or dorsal cutaneous, transverse rectus abdominis myocutaneous, cremaster, spinotrapezius, or gastrocnemius muscular), and evaluation time points (5 minutes to 21 days). Better flap survival rates, 10,22,32,36,39,50,54,57 increased angiogenesis and angiogenic marker expression, 36,39,40,49,50,54 improved blood flow, 54,57 vasodilation, 8,39,50,62 and reduced inflammation and inflammatory marker expression 1,6 were observed in the BTX treatment groups as compared to controls. Interestingly, BTX-A also improved random cutaneous flap survival in rats after short-and long-term tobacco exposure, demonstrating its potential efficacy for the prevention of reconstructive and revascularization surgery complications in smokers.…”

Section: Btx-a Utility In Vasospasm Prevention: Relevant Animal Studiesmentioning

confidence: 89%

“…Interestingly, BTX-A also improved random cutaneous flap survival in rats after short-and long-term tobacco exposure, demonstrating its potential efficacy for the prevention of reconstructive and revascularization surgery complications in smokers. 10,36 Although these animal studies provide valuable insights into the potential benefit of BTX in revascularization surgery, marked differences in innervation and response to spasmogens have been demonstrated between human and animal blood vessels. 26,28,29 The first translational application of BTX-A for cerebrovascular bypass graft spasm prevention in humans was only recently published.…”

Section: Btx-a Utility In Vasospasm Prevention: Relevant Animal Studiesmentioning

confidence: 99%

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Role of botulinum neurotoxin–A in cerebral revascularization graft vasospasm prevention: current state of knowledge

Rāviņa¹,

Strickland

Rennert

et al. 2019

Neurosurgical Focus

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Graft stenosis and occlusion remain formidable complications in cerebral revascularization procedures, which can lead to significant morbidity and mortality. Graft vasospasm can result in early postoperative graft stenosis and occlusion and is believed to be at least partially mediated through adrenergic pathways. Despite various published treatment protocols, there is no single effective spasmolytic agent. Multiple factors, including anatomical and physiological variability in revascularization conduits, patient age, and comorbidities, have been associated with graft vasospasm pathogenesis and response to spasmolytics. The ideal spasmolytic agent thus likely needs to target multiple pathways to exert a generalizable therapeutic effect. Botulinum toxin (BTX)–A is a powerful neurotoxin widely used in clinical practice for the treatment of a variety of spastic conditions. Although its commonly described paradigm of cholinergic neural transmission blockade has been widely accepted, evidence for other mechanisms of action including inhibition of adrenergic transmission have been described in animal studies. Recently, the first pilot study demonstrating clinical use of BTX-A for cerebral revascularization graft spasm prevention has been reported. In this review, the mechanistic basis and potential future clinical role of BTX-A in graft vasospasm prevention is discussed.

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Section: Btx-a Utility In Vasospasm Prevention: Relevant Animal Studiesmentioning

confidence: 89%

Section: Btx-a Utility In Vasospasm Prevention: Relevant Animal Studiesmentioning

confidence: 99%

Role of botulinum neurotoxin–A in cerebral revascularization graft vasospasm prevention: current state of knowledge

Rāviņa¹,

Strickland

Rennert

et al. 2019

Neurosurgical Focus

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“…The protective effects of BoNT/A on flap survival in rats have been independently reported by several research groups . In one study, BoNT/A was used to prevent unfavourable effects of cigarette smoke in Wistar albino rats . In another study, it increased skin‐flap viability in diabetic rats, which was associated with an increase of lumen diameter, external arterial diameter and lumen/wall thickness ratio .…”

Section: Experimental Studies Of Cutaneous Effects Of Botulinum Neuromentioning

confidence: 95%

The non-neuronal and nonmuscular effects of botulinum toxin: an opportunity for a deadly molecule to treat disease in the skin and beyond

Grando

Zachary

2018

Br J Dermatol

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There is growing evidence that botulinum neurotoxins (BoNTs) exhibit biological effects on various human cell types with a host of associated clinical implications. This review aims to provide an update on the non-neuronal and nonmuscular effects of botulinum toxin. We critically analysed recent reports on the structure and function of cellular signalling systems subserving biological effects of BoNTs. The BoNT receptors and intracellular targets are not unique for neurotransmission. They have been found in both neuronal and non-neuronal cells, but there are differences in how BoNT binds to, and acts on, neuronal vs. non-neuronal cells. The non-neuronal cells that express one or more BoNT/A-binding proteins, and/or cleavage target synaptosomal-associated protein 25, include: epidermal keratinocytes; mesenchymal stem cells from subcutaneous adipose; nasal mucosal cells; urothelial cells; intestinal, prostate and alveolar epithelial cells; breast cell lines; neutrophils; and macrophages. Serotype BoNT/A can also elicit specific biological effects in dermal fibroblasts, sebocytes and vascular endothelial cells. Nontraditional applications of BoNT have been reported for the treatment of the following dermatological conditions: hyperhidrosis, Hailey-Hailey disease, Darier disease, inversed psoriasis, aquagenic palmoplantar keratoderma, pachyonychia congenita, multiple eccrine hydrocystomas, eccrine angiomatous hamartoma, eccrine sweat gland naevi, congenital eccrine naevus, Raynaud phenomenon and cutaneous leiomyomas. Experimental studies have demonstrated the ability of BoNT/A to protect skin flaps, facilitate wound healing, decrease thickness of hypertrophic scars, produce an anti-ageing effect, improve a mouse model of psoriasiform dermatitis, and have also revealed extracutaneous effects of BoNT arising from its anti-inflammatory and anticancer properties. BoNTs have a much wider range of applications than originally understood, and the individual cellular responses to the cholinergic impacts of BoNTs could provide fertile ground for future studies.

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“…This may preclude ablative resurfacing in some situations, and resurfacing should only be pursued with caution by an experienced physician. Most physicians performing full-field ablative laser resurfacing require smoking cessation, to optimize wound healing, prior to laser treatment [21,22].…”

Section: Patient Selectionmentioning

confidence: 99%

Skin Resurfacing

Kupcha¹,

Biesman²

2020

Albert and Jakobiec's Principles and Practice of Ophthalmology

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Prevention of unfavourable effects of cigarette smoke on flap viability using botulinum toxin in random pattern flaps: An experimental study

Abstract: Preoperative administration of BTX significantly enhanced flap viability in the rats exposed to CS. Further human studies are warranted to verify whether BTX type A could be used as an agent to reduce the risk of flap necrosis in patients who smoke.

Cited by 13 publications

References 64 publications

Role of botulinum neurotoxin–A in cerebral revascularization graft vasospasm prevention: current state of knowledge

Role of botulinum neurotoxin–A in cerebral revascularization graft vasospasm prevention: current state of knowledge

The non-neuronal and nonmuscular effects of botulinum toxin: an opportunity for a deadly molecule to treat disease in the skin and beyond

Skin Resurfacing

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