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Hydroxysafflor yellow A promotes multiterritory perforating flap survival: an experimental study.

ABSTRACT: The use of perforator flaps is a common surgical technique in wound repair. However, the area surrounding the multiterritory perforating flap often becomes necrotic due to ischemia. Hydroxysafflor yellow A (HSYA), a traditional Chinese medicine extracted from edible safflower, can be used medicinally to promote angiogenesis, inhibit apoptosis, and alleviate oxidative stress and other biological activities. Here, we investigated the effect of HSYA on perforator flap survival and its potential mechanism. Our results demonstrate that HSYA significantly improves the survival area of perforator flaps, increases blood supply, reduces tissue edema, and increases mean vascular density. HSYA treatment promotes angiogenesis and inhibits oxidative stress, apoptosis, and autophagy in perforator flaps, suggesting many potential mechanisms for flap survival.

SUBMITTER: Zhang C

PROVIDER: S-EPMC7476167 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Hydroxysafflor yellow A promotes multiterritory perforating flap survival: an experimental study.

Zhang Chenxi C Shao Zhenxuan Z Chen Zhentai Z Lin Chen C Hu Sunli S Lou Zhiling Z Li Jiafeng J Zheng Xuanqi X Lin Nan N Gao Weiyang W

American journal of translational research 20200815 8

The use of perforator flaps is a common surgical technique in wound repair. However, the area surrounding the multiterritory perforating flap often becomes necrotic due to ischemia. Hydroxysafflor yellow A (HSYA), a traditional Chinese medicine extracted from edible safflower, can be used medicinally to promote angiogenesis, inhibit apoptosis, and alleviate oxidative stress and other biological activities. Here, we investigated the effect of HSYA on perforator flap survival and its potential mec ...[more]

PMID: 32913550

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Project description:BackgroundArterialized vein flap is a kind of unphysiological flap. Unphysiological reconstruction of blood circulation leads to higher load than that supported by physiological flap and is the culprit of flap swelling, blood stasis, skin blistering, and necrosis after flap grafting. To resolve the multiple disadvantages of traditional flap grafting, by introducing the principles of fluid mechanics, shunt-decompression surgery is prepared to decline the circulation preload and improve the prognosis of arterialized vein flap grafting.MethodsBy introducing the principles of fluid mechanics, we established the model of shunt-decompression arterialized vein flap, which satisfied the common properties of general fluid that the interface pressure between object and fluid is reduced when the velocity of fluid is increased and vice versa-the effect of Bernoulli. Under this rule, we anastomose the arterialized vein to the branch of main artery of recipient region or make end-to-side anastomosis, which can maintain the blood flow of main artery, decrease the perfusion of flap, and preserve the decompressive effect of main artery to branches. From March, 2016 to September, 2016, we performed animal experiments on ten male bama mini pigs with average weight of 28?±?2.35 kg. Superior epigastric artery of pig was used for feeding artery to arterialize the superficial epigastric veins. The total area of flap is 8 cm?×?6 cm. End-to-side anastomosis and end-to-end anastomosis were established in experimental group and control group, respectively. Doppler speckle perfusion imaging apparatus was used to monitor the alterations of flap perfusion, blood flow of flap, tissue swelling and survival of flaps.ResultsThe average flap perfusion (PU) at 1 week after surgery is 83.62?±?3.14 in experimental group and 98.14?±?6.54 in control group, respectively (P?<?0.05), indicating the significant reduction of flap blood perfusion in experimental group as compared with control group. As to the survival of flaps, 7 flaps completely survived, 3 showed partial necrosis, and no one was found as complete necrosis in experimental group, while only 3 flaps survived, and 4 flaps and 3 flaps showed partial necrosis and complete necrosis in control group, respectively (P?<?0.05).ConclusionBased on the physiological features of arterialized vein flap and its problems in clinical application, we improved the anastomosis strategy of flap grafting and obtained excellent experimental outcomes, which provides an insight for the clinical application of arterialized vein flaps.

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Hydroxysafflor yellow A promotes multiterritory perforating flap survival: an experimental study.

Publications

Hydroxysafflor yellow A promotes multiterritory perforating flap survival: an experimental study.

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