Role of Nitric Oxide in Surgical Flap Survival

Topp, Shelby G.; Zhang, Feng; Chatterjee, Tanya; Lineaweaver, William C.

doi:10.1016/j.jamcollsurg.2005.05.026

Cited by 20 publications

(15 citation statements)

References 93 publications

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“…41,42 NO has also been shown to enhance ischemic tissue survival. [43][44][45] The present report demonstrates for the first time a critical role for TSP1 in controlling survival of FTSG by limiting the beneficial effects of NO. In the absence of endogenous TSP1, or its receptor CD47, significant increases in survival of FTSG were achieved.…”

Section: Discussionmentioning

confidence: 51%

Blockade of Thrombospondin-1-CD47 Interactions Prevents Necrosis of Full Thickness Skin Grafts

Isenberg¹,

Pappan²,

Romeo³

et al. 2008

Annals of Surgery

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Section: Discussionmentioning

confidence: 51%

Blockade of Thrombospondin-1-CD47 Interactions Prevents Necrosis of Full Thickness Skin Grafts

Isenberg¹,

Pappan²,

Romeo³

et al. 2008

Annals of Surgery

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“…112,113 VEGF interactions with the complex cascades of NO metabolism may take different routes in different tissues under various circumstances of ischemia. 114 NOS and NO are known to be two of the most important factors in promoting flap viability and angiogenesis. Inducible NOS (iNOS) can aid skin flap viability in a rat model.…”

Section: Pathway Of Vegf Cascadementioning

confidence: 99%

Effects of Vascular Endothelial Growth Factor on Survival of Surgical Flaps: A Review of Experimental Studies

Fang

Lineaweaver

Chen

et al. 2013

J reconstr Microsurg

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Partial or complete necrosis of skin flaps remains a significant problem in plastic and reconstructive surgery. Growth factors have shown promise in improving flap survival through increased angiogenesis and blood supply to the flap. Vascular endothelial growth factor (VEGF) is the most widely investigated and successful one. But the mechanisms of the effects are still not very clear. In the course of a series of experiments, we indicated that tissue survival of surgical flaps could be improved by both preoperative (sustained phase effect) and intraoperative (acute phase effect) application of VEGF. We reviewed both experimental and clinical investigations on the use of VEGF with surgical flaps to summarize the evidence of both phases of VEGF activity in promotion of flaps survival in detail. With the combinations of acute and sustained phases of effects, VEGF protein and gene, VEGF morphologic actions, and VEGF histochemical modulations suggest a pattern of VEGF activity that can be superimposed on classic descriptive mechanisms of tissue survival of flaps.

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“…It is involved in many physiological and pathological processes. Low levels of iNOS expression have been proven to play an important role in protecting flaps from I/R injury [2,12,13].…”

Section: Introductionmentioning

confidence: 99%

Expression of inducible nitric oxide synthase in muscle flaps treated with ischemic postconditioning

Yang

Angel

Pang

et al. 2012

HAND

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Background/Objective Preconditioning has been considered promising for the treatment of ischemic flaps. In this study, the therapeutic effect of postconditioning was compared with that of preconditioning during ischemia/reperfusion (I/R) injury, and a role of inducible nitric oxide synthase (iNOS) in postconditioning treatment was also explored. Methods Sixty rats were randomly divided into four groups with 15 rats in each group. Ischemic injury was induced in a rat's gracilis muscle flap model. Preconditioning and postconditioning were performed respectively on the flaps in the pre-con group and the post-con group. No treatment was given to the flaps in the control group, and flaps without I/R injury were used as a sham control. Muscle viability ratio, histology, and gene expression of iNOS were examined at different time intervals (3, 12, and 18 h). Results A significantly higher survival ratio was observed in both the pre-con group (78.98±3.39, 62.74±3.7, and 54.42 ± 4.45 %) and the post-con group (77.42 ± 4.14, 59.74±6.67, and 49.52±4.13 %) than the control group (45.22±3.69, 42.44±3.76, and 33.2±3.29 %) at 3, 12, and 18 h postoperatively (P<0.05). There was no statistical difference between the pre-con group and the post-con group (P>0.05). Histological examination showed delayed and attenuated tissue damage in both the pre-con group and the post-con group when compared to that of the control group. A higher expression of iNOS was observed in both the pre-con group and the post-con group than the control group and the sham group (P<0.05). Conclusions Significant improvement of flap survival could be achieved by both preconditioning and postconditioning treatments; however, better protection could be provided by preconditioning. The higher expression of iNOS may play an important role in the therapeutic effect of postconditioning during I/R injury.

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Role of Nitric Oxide in Surgical Flap Survival

Cited by 20 publications

References 93 publications

Blockade of Thrombospondin-1-CD47 Interactions Prevents Necrosis of Full Thickness Skin Grafts

Blockade of Thrombospondin-1-CD47 Interactions Prevents Necrosis of Full Thickness Skin Grafts

Effects of Vascular Endothelial Growth Factor on Survival of Surgical Flaps: A Review of Experimental Studies

Expression of inducible nitric oxide synthase in muscle flaps treated with ischemic postconditioning

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