Polidocanol injection for chemical delay and its effect on the survival of rat dorsal skin flaps

Heme oxygenase‑1 improves the survival of ischemic skin flaps (Review)

“…in addition, Sanati-Mehrizy et al (4) reported that smoking and operation time are risk factors for free flap necrosis and de Blacam et al (7) found that venous congestion and increased age are risk factors for pedicle flap failure. Current literature regarding the risk factors of skin flap necrosis mainly focus on free skin flaps and lower limb pedicled skin flaps (8)(9)(10)(11)(12)(13)(14)(15), and treatment methods that have been proposed are based on various mechanisms such as surgical delay, chemical delay, extracorporeal shock wave therapy, local thermal pretreatment, percutaneous neuroelectric pretreatment, cold pretreatment, negative pressure suction, targeted gene therapy, and drug injection (16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Heat shock proteins (Hsps), which are highly evolutionarily conserved from prokaryotes to human (26), are molecular chaperons that exhibit a variety of biological activities including anti-oxidative, anti-apoptotic and anti-inflammatory effects (27).…”

Value of remote ischaemic preconditioning in rat dorsal skin flaps and clamping time

“…Therefore, if a long flap must be created, ''delay'' procedures are used to prevent skin flap necrosis, including surgical delay by means of two-stage surgery [12], pharmacological delay through the use of drugs [13][14][15], and supercharging, but as yet there is no safe, low-cost, simple method of delay that does not require two-stage surgery.…”

The Influence of Topical Vasodilator-Induced Pharmacologic Delay on Cutaneous Flap Viability and Vascular Remodeling

“…Prior investigations attempting to replicate the delay phenomenon using nonsurgical methods, including sympatholytics, direct vasodilators, and eicosanoid pathway modulators, have yielded mixed results. [16][17][18][19][20][21][22][23] However, pharmacologic delay with vasodilators, including topical minoxidil, a U.S. Food and Drug Administration-approved topical vasodilator in the treatment of androgenic alopecia, has been shown to effectively reduce flap necrosis. 24 Iloprost, a stable prostacyclin I2 analogue, is another topical vasoactive agent shown in several studies to enhance skin flap survival as a topical and injectable agent.…”