Abstract
Random-pattern skin flap replantation is generally used in the reconstruction of surgical tissues and covering a series of skin flap defects. However, ischemia often occurs at the flap distal parts, which lead to flap necrosis. Previous studies have shown that andrographolide (Andro) protects against ischemic cardiovascular diseases, but little is known about the effect of Andro on flap viability. Thus, our study aimed to building a model of random-pattern skin flap to understand the mechanism of Andro-induced effects on flap survival. In this study, fifty-four mice were randomly categorized into the control, Andro group, and the Andro+3-methyladenine group. The skin flap samples were obtained on postoperative day 7. Subsequently, the tissue samples were underwent a series of evaluations such as changes in the appearance of flap tissue, the intensity of blood flow, and neovascularization density of skin flap. In our study, the results revealed that Andro enhanced the viability of random skin flaps by enhancing angiogenesis, inhibiting apoptosis, and reducing oxidative stress. Furthermore, our results have also demonstrated that the administration of Andro caused an elevation in the autophagy, and these remarkable impact of Andro were reversed by 3-methyladenine (3-MA), the most common autophagy inhibitor. Together, our data proves novel evidence that Andro is a potent modulator of autophagy capable of significantly increasing random-pattern skin flap survival.
Highlights
The random-pattern skin flap is commonly used in the reconstruction of defective skin tissues because it is a simple, reliable, and convenient tool (Chehelcheraghi et al, 2016; Fichter et al, 2016; Pu et al, 2017)
Various published studies demonstrated that the injuryAndrographolide Promoted Skin Flaps Survival (IRI) induces reactive oxygen species (ROS) accumulation and apoptosis of functional cells, which contribute to necrosis of skin flap (Gurlek et al, 2006; van den Heuvel et al, 2009; Ren et al, 2018)
On day seventh after surgery, the necrosis in the dorsum of the skin was larger and darker compared with the groups on day 3
Summary
The random-pattern skin flap is commonly used in the reconstruction of defective skin tissues because it is a simple, reliable, and convenient tool (Chehelcheraghi et al, 2016; Fichter et al, 2016; Pu et al, 2017). Various published studies demonstrated that the IRI induces ROS accumulation and apoptosis of functional cells, which contribute to necrosis of skin flap (Gurlek et al, 2006; van den Heuvel et al, 2009; Ren et al, 2018). Considering these mechanisms, the potential treatments can start with promoting angiogenesis, reducing oxidative stress and apoptosis
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