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. 2017 Oct 6;8(55):94142-94150.
doi: 10.18632/oncotarget.21589. eCollection 2017 Nov 7.

Naringin improves random skin flap survival in rats

Liang Cheng  1 , Tingxiang Chen  1 , Qiming Tu  1 , Hang Li  1 , Zhenghua Feng  1 , Zhijie Li  1 , Dingsheng Lin  1
Affiliations

Naringin improves random skin flap survival in rats

Liang Cheng et al. Oncotarget. .

Abstract

Background: Random-pattern flap transfer is commonly used to treat soft-tissue defects. However, flap necrosis remains a serious problem. Naringin accelerates angiogenesis by activating the expression of vascular endothelial growth factor (VEGF). In the present study, we investigated whether naringin improves the survival of random skin flaps.

Results: Compared with controls, the naringin-treated groups exhibited significantly larger mean areas of flap survival, significantly increased SOD activity and VEGF expression, and significantly reduced MDA level. Hematoxylin and eosin (HE) staining revealed that naringin promoted angiogenesis and inhibited inflammation.

Materials and methods: "McFarlane flap" models were established in 90 male Sprague-Dawley (SD) rats divided into three groups: a 40 mg/kg control group (0.5 % sodium carboxymethylcellulose), a 40 mg/kg naringin-treated group, and an 80 mg/kg naringin-treated group. The extent of necrosis was measured 7 days later, and tissue samples were subjected to histological analysis. Angiogenesis was evaluated via lead oxide-gelatin angiography, immunohistochemistry, and laser Doppler imaging. Inflammation was evaluated by measurement of serum TNF-α (tumor necrosis factor-α) and IL-6 (interleukin-6) levels. Oxidative stress was assessed by measuring superoxide dismutase (SOD) activity and the malondialdehyde (MDA) level.

Conclusion: Naringin improved random skin flap survival.

Keywords: angiogenesis; inflammation; naringin; random flap survival; rat.

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Conflict of interest statement

CONFLICTS OF INTEREST The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1. Digital photographs of flaps from the three groups and the necrosis parts were outlined by red line
Figure 2
Figure 2. Percentage of survival area on day 7 in three groups (**p < 0.01 vs. the control group)
Figure 3
Figure 3
(A) Histological changes in the each area of the flaps in the three groups (100 and 200 magnification). (B) The MVDs of area II in the three groups (**p < 0.01 vs. the control group). Yellow arrow indicated the microvascular and white arrow indicated the neutrophil cells.
Figure 4
Figure 4. Flap angiography presenting flaps from the three groups
Figure 5
Figure 5
(A) Comparison of VEGF expression in the intermediate area II of the three groups. The immunohistochemistry test and observed under magnification 200. (B) IA value was detected to compare the level of VEGF (**p < 0.01 vs. the control group). IA, integral absorbance; VEGF, vascular endothelial growth factor.
Figure 6
Figure 6
(A) The blood perfusion on day 7 in three groups. (B) Mean blood flow of the second choke zone in the flap in three groups measured by laser Doppler imaging at day 7 after surgery (**p < 0.01 vs. the control group).
Figure 7
Figure 7
(A, B) The expression of the flap inflammation reaction factor (TNF-a, IL-6) (**p < 0.01 vs. the control group). (C, D) The expression of the flap oxidative stress factor (SOD, MDA) (**p < 0.01 vs. the control group).
Figure 8
Figure 8
(A) A McFarlane flap model was designed (3×9 cm) and three parts were divided (I, II, and III); (B) no axial vessels were incorporated into the flap; (C) the rats had a self-mutilation tendency and they would bite the flaps on their back and cause flap injuries; (D) the rats were fitted with a neck collar to prevent self-mutilation.
See this image and copyright information in PMC

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