Abstract
The purpose of this study was to determine the effectiveness of topically applied minoxidil in the pharmacological delay phenomenon and to demonstrate the comparable microscopic and macroscopic changes between minoxidil-pretreated flaps and surgically delayed flaps. A modified version of the McFarlane flap was used. Group 1 rats, in which a caudally based dorsal skin flap was raised and sutured back, were the control group. In group II, minoxidil solution was spread over the marked skin flap area for 7 days. On the 7th day, a caudally based dorsal skin flap was elevated and then sutured back. Group III rats underwent a surgical delay procedure alone. On the 7th day after flap elevation, evaluation was done by histologic examination and calculation of the flap survival areas in all groups. The lowest flap survival rate appeared in group I and was statistically different from groups II and III. The mean surviving skin flap area in the minoxidil-pretreated group was significantly larger than that in the control group. After histologic evaluation, moderate angiogenesis was also detected in group II. We also found that surgical delay significantly reduced flap necrosis when compared to the minoxidil pretreatment group. According to our study, minoxidil may be considered an effective vasoactive agent for the stimulation of angiogenesis in rat cutaneous flaps and capable of achieving pharmacological delay and increasing flap survival.
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References
Beheshtian A, Demehri S, Kiumehr S, Salmasi AH, Nezami BG, Rahimpour S, Amanpour S, Rabbani S, Mohagheghi MA, Dehpour AR (2006) ATP-sensitive potassium channels mediate the anti-ischemic properties of ischemic and pharmacologic preconditioning in rat random-pattern skin flap. Ann Plast Surg 57(1):94–99
Gözü A, Poda M, Taşkin EI, Turgut H, Erginel-Unaltuna N, Doğruman H, Ozsoy Z (2010) Pretreatment with octreotide modulates iNOS gene expression, mimics surgical delay, and improves flap survival. Ann Plast Surg 65(2):245–249
Lineaweaver WC, Lei MP, Mustain W, Oswald TM, Cui D, Zhang F (2004) Vascular endothelium growth factor, surgical delay, and skin flap survival. Ann Surg 239(6):866–873
Erçöçen AR, Kono T, Kikuchi Y, Kitazawa Y, Nozaki M (2003) Efficacy of the flashlamp-pumped pulsed-dye laser in nonsurgical delay of skin flaps. Dermatol Surg 29(7):692–699
Yildirim AM, Okur I, Orter Z, Uysal A (2008) Nonsurgical delay of dorsal rat cutaneous flap using botulinum toxin type A. Plast Reconstr Surg 122(1):53e–54e
McFarlane RM, DeYoung G, Henry RA (1965) The design of a pedicle flap in the rat to study necrosis and its prevention. Plast Reconstr Surg 35:177–182
Khouri RK, Angel MF, Edstrom LE (1986) Standardizing the dorsal rat flap. Plast Surg 37:590–591
Headington JT (1987) Hair follicle biology and topical minoxidil: possible mechanisms of action. Dermatologica 175(Suppl 2):19–22
Smorlesi C, Caldarella A, Caramelli L, Di Lollo S, Moroni F (2003) Topically applied minoxidil may cause fetal malformation: a case report. Birth Defects Res A 67(12):997–1001
DeVillez RL (1990) The therapeutic use of topical minoxidil. Dermatol Clin 8(2):367–375
Meisheri KD, Cipkus LA, Taylor CJ (1988) Mechanism of action of minoxidil sulfate-induced vasodilation: a role for increased K+ permeability. J Pharmacol Exp Ther 245(3):751–760
Wester RC, Maibach HI, Guy RH, Novak E (1984) Minoxidil stimulates cutaneous blood flow in human balding scalps: pharmacodynamics measured by laser Doppler velocimetry and photopulse plethysmography. J Invest Dermatol 82(5):515–517
Pavlovitch JH, Hubert H, Leibovitch J (1990) Angiogenesis and minoxidil. Lancet 336(8719):889
Whitmore SE, Wigley FM, Wise RA (1995) Acute effect of topical minoxidil on digital blood flow in patients with Raynaud’s phenomenon. J Rheumatol 22(1):50–54
Smith DK, Dolan RW (1999) Effects of vasoactive topical agents on the survival of dorsal skin flaps in rats. Otolaryngol Head Neck Surg 121(3):220–223
Bittencourt Rde C, Biondo-Simões Mde L, Paula JB, Martynetz J, Groth A (2005) Influence of minoxidil on ischemic cutaneous flaps in rats. Acta Cir Bras 20(6):450–454
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The authors have no conflicts of interest or financial ties to disclose. Furthermore, this study was not supported by any external funding, nor were any special products, devices, or drugs used in the work presented.
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Gümüş, N., Ödemiş, Y., Tuncer, E. et al. The Effect of Topical Minoxidil Pretreatment on Nonsurgical Delay of Rat Cutaneous Flaps: Further Studies. Aesth Plast Surg 37, 809–815 (2013). https://doi.org/10.1007/s00266-013-0161-x
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DOI: https://doi.org/10.1007/s00266-013-0161-x