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. 2016 Sep 26;21(10):1262.
doi: 10.3390/molecules21101262.

Effects of Sanguis Draconis on Perforator Flap Survival in Rats

Yang Zhang  1 , Xiaobing Cai  2 , Lifeng Shen  3 , Xiaowen Huang  4 , Xuping Wang  5 , Yinan Lan  6 , Dan Shou  7
Affiliations

Effects of Sanguis Draconis on Perforator Flap Survival in Rats

Yang Zhang et al. Molecules. .

Abstract

Sanguis draconis, a resin known to improve blood circulation, relieve pain, stimulate tissue regeneration, and heal wounds, is widely used in clinical practice. In this study, we prepared an ethanol extract of sanguis draconis (EESD) containing 75.08 mg/g of dracorhodin. The experiment was carried out on 20 rats that were divided into two groups, a control group (n = 10) and an EESD group (n = 10). All the rats underwent a perforator flap surgery, after which post-operative abdominal compressions of EESD were given to the EESD group for seven days, while the control group received saline. Flap survival percentages were determined after seven days, and were found to be significantly higher in the EESD group than in the control group. Results of laser Doppler flowmetry (LDF) showed that perforator flaps in the EESD group had higher perfusion values than those of the control group. The flap tissues were stained with hematoxylin and eosin, followed by immunohistochemical evaluation. Superoxide dismutase (SOD) expression and micro-vessel development markedly increased in the EESD group, while malondialdehyde (MDA) levels decreased. This is the first study to investigate the effect of sanguis draconis on perforator flap survival. Our results demonstrate that sanguis draconis can improve perforator flap survival in rats by promoting microvessel regeneration and blood perfusion.

Keywords: dracorhodin; flap survival; microvessels; perforator flaps; perfusion; sanguis draconis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Chromatogram of dracorhodin in EESD (A) and in the standard (B).
Figure 2
Figure 2
These digital images, taken on the third and seventh post-operative days, display the general form of perforator flaps in the EESD and control groups.
Figure 3
Figure 3
The hematoxylin and eosin stain images, taken before the operation and on the seventh post-operative day, display the histological changes in the middle areas A, B, and C of the flaps in the EESD and control groups. Magnification: × 100 (hematoxylin and eosin stain). The black arrow shows neovascularization, the blue arrow shows tissue necrosis, the green arrow shows tissue edema, the yellow arrow shows neutrophilic infiltration, and the orange arrow shows fibroblast proliferation.
Figure 4
Figure 4
The histogram displays the MVDs (micro-vascular densities) of areas A, B, and C in the EESD and control groups. MVD, micro-vascular density. * p < 0.01 compared to the control group.
Figure 5
Figure 5
(A) The immunohistochemical stain images, taken before the operation and on the seventh post-operative day, display the expression of VEGF (vascular endothelial growth factor) in the perforator flaps; (B) The histogram displays the IOD (integrated optical density) valued of VEGF in the two groups. * p < 0.01 compared to the control group.
Figure 6
Figure 6
(A) The histogram displays the SOD (superoxide dismutase) serum activity in the EESD and control groups; (B) The histogram displays the MDA (Malondialdehyde) serum levels in the EESD and control groups; (C) The histogram displays the SOD activities in area C of the skin flap in the EESD and control groups; (D) The histogram displays the MDA levels in area C of the skin flap in the EESD and control groups. ** p < 0.01 compared to the control group.
Figure 7
Figure 7
(A) The triangular boundary on the abdominal skin; (B) the perforator flaps divided into three zones: top (area A), intermediate (area B), and distal (area C) zones; (C) the epigastric artery on the perforator flap; (D) the epigastric perforator flap with a solitary perforator; (E,F) EESD applied on the perforator flap after the operation.
See this image and copyright information in PMC

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