Abstract
The random-pattern flap has a significant application in full mouth restoration (reconstructive surgery) and plastic surgery owing to an easy operation with no axial vascular restriction. However, distal necrosis after flap operation is still considered the most common complication which makes it the Achilles heel in the clinical application of random-pattern flaps. A Chinese medicinal herb named gastrodin is an effective active ingredient of Gastrodia. Herein, the existing study explored the significant potential of gastrodin on flap survival and its underlying mechanism. Our obtained results show that gastrodin will significantly improve flap survival, reduce tissue edema, and increase blood flow. Furthermore, our studies reveal that gastrodin can promote angiogenesis and reduce the apoptotic process as well as oxidative stress. The results of immunohistochemistry and immunoblotting revealed that gastrodin has a role in the elevation of autophagy flux which results in induced autophagy. The use of 3MA (3-methyladenine) for the inhibition of induced autophagy significantly weakened the underlying benefits of gastrodin treatment. Taken together, our obtained results confirmed that gastrodin is an effective drug that can considerably promote the survival rate of flaps (random pattern) via enhancing autophagy. Enhanced autophagy is correlated with the elevation of angiogenesis, reduced level of oxidative stress, and inhibition of cell apoptosis.
Highlights
Skin flap transfer is a form of transplantation that is widely used in plastic and reconstructive surgery
Angiogenesis has been very low at the flap distal end, which leads to tissue necrosis in the underlying area that is mostly caused by insufficient angiogenesis [7]
We explored whether the positive effect of gastrodin on flap survival may be obtained via enhancing angiogenesis
Summary
Skin flap transfer is a form of transplantation that is widely used in plastic and reconstructive surgery. Random-pattern skin flaps have become one of the most considerably and highly used techniques to cure multiple defects in tissues. It is mostly used for the reconstruction of skin defects that are correlated with congenital diseases, trauma, diabetes, and cancer-related abnormalities [1, 2] [3], blood circulation is not specific in flaps (randompattern) and is mostly associated with the development of flap necrosis after surgery. Considering the underlying mechanisms, in view of the Oxidative Medicine and Cellular Longevity widespread use of random flaps in clinical practice and the high rate of flap necrosis, the potential approaches that enhance angiogenesis and decrease oxidative stress and cellular apoptosis have been well studied in recent decades. Medical treatments should be emphasized to improve flap survival
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