The effects of resveratrol on flap survival in diabetic rats

Abstract

Resveratrol is an antioxidant agent with multiple positive impacts on the body. It is known to have anti-diabetic, anti-inflammatory, anti-carcinogenic, and neuroprotective effects. The goal of this study is to demonstrate the antioxidant and anti-diabetic effects of resveratrol on flap survival in diabetic rats. Streptozotocin-induced diabetic Sprague-Dawley albino rats were treated with 10 mg/kg resveratrol following a flap surgery. Histological findings regarding polymorphonuclear leukocyte (PMNL) density, vascular proliferation, fibroblast density, and tissue necrosis were compared between resveratrol-treated and control rats. Significantly higher PMNL density was found in the control group (p = 0.005); while vascular proliferation and the fibroblast density were higher in the resveratrol group (p = 0.004 and p = 0.021, respectively). Collagen density was also higher in the resveratrol group and the difference has statistical significance (p = 0.024). Lymphocyte density was not significantly different between groups (p = 0.061). When the necrosis in the distal areas was evaluated histologically, 20% of the resveratrol group had epidermal tissue necrosis, thus 90% of the control group had epidermal or full-layer necrosis. Resveratrol improved flap survival significantly in diabetic rats. Therefore, diabetic patients requiring complex reconstructive procedures may benefit from resveratrol; so, clinical trials are required to support this study.

Tissue-Protective Mechanisms of Bioactive Phytochemicals in Flap Surgery

“…Several studies reported that resveratrol increases the expression of HO-1 in an Nrf-2-dependent manner ( Gao et al, 2018 ; Zhang Y. et al, 2020 ; Lian et al, 2020 ). In line with this finding, the administration of resveratrol elevated the expression of HO-1 and SOD-1 in random pattern flaps of rats, which was associated with a lower apoptosis rate ( Ciloglu et al, 2014 ; Lin J. et al, 2019 ). Moreover, luteolin and ginkgolide B triggered the gene expression of Nrf-2, leading to elevated HO-1 mRNA levels and higher viability of surgical flaps ( Chen G. et al, 2018 ; Lin D. et al, 2019 ).…”

“…Additional examples of phytochemicals with a high pro-angiogenic activity promoting flap survival are resveratrol ( Ciloglu et al, 2014 ; Lin J. et al, 2019 ), betulinic acid ( Li et al, 2019 ), salvianolic acid B ( Lay et al, 2003 ; Lin J. et al, 2018 ), and hydroxysafflor yellow A ( Zhang C. et al, 2020 ). All of these compounds simultaneously increase the expression of VEGF and matrix metalloproteinases (MMPs).…”

Beneficial effects of Xuebijing injection on random skin flap survival in rats

“…Previous studies [3,4] have confirmed that ischemiaereperfusion (I/R) injury and neutrophil infiltration result in flap necrosis. Various kinds of agents have been tested to prevent skin flap ischemia, such as resveratrol [5], heparin [6], and vascular endothelial growth factor (VEGF) [7]. Xuebijing (XBJ) injection is an intravenous preparation made from five traditional Chinese medicines, namely Chishao (Radix Paeoniae Rubra), Danggui (Radix Angelica Sinensis), Chuanxiong (Rhizoma Chuanxiong), Honghua (Flos Carthami), and Danshen (Radix Salviae Miltiorrhizae) [8].…”