Document Detail

Pharmacologic enhancement of rat skin flap survival with topical oleic acid.
MedLine Citation:
PMID:  15253195     Owner:  NLM     Status:  MEDLINE    
This study was instituted to investigate in a rat model the effect of topical coadministration of the penetration enhancer oleic acid (10% by volume) and RIMSO-50 (medical grade dimethyl sulfoxide, 50% by volume) on rat skin flap survival. A rectangular abdominal skin flap (2.5 x 3 cm) was surgically elevated over the left abdomen in 40 nude rats. The vein of the flap's neurovascular pedicle was occluded by placement of a microvascular clip, and the flap was resutured with 4-0 Prolene to its adjacent skin. At the end of 8 hours, the distal edge of the flap was reincised to gain access to the clips and the clips were removed. After resuturing of the flap's distal edge to its adjacent skin, the 40 flaps were randomly divided into four groups. Group 1 (control) flaps were treated with 5 g of saline, group 2 (dimethyl sulfoxide) flaps were treated with 2.7 g of dimethyl sulfoxide (50% by volume), group 3 flaps (oleic acid) were topically treated with 0.45 g of oleic acid (10% by volume), and group 4 (dimethyl sulfoxide plus oleic acid) flaps were treated with a mixture of 0.45 g of oleic acid (10% by volume) and 2.7 g of dimethyl sulfoxide (50% by volume) diluted in saline. Each flap was topically treated with 5 ml of drug-soaked gauze for 1 hour immediately after clip removal to attenuate reperfusion injury. Thereafter, drug was applied topically once daily for 4 more days. Digital photographs of each flap were then taken on day 6 and the flaps were then harvested. The percentage of skin survival in each flap was determined by computerized morphometry and planimetry. The mean surviving area of group 3 (oleic acid-treated flaps) was 23.60 +/- 4.19 percent and was statistically higher than that in group 1 (control, saline-treated flaps) at 7.20 +/- 2.56 percent. The mean surviving area of group 2 (dimethyl sulfoxide-treated flaps) at 18.00 +/- 5.23 percent and group 4 (oleic acid- and dimethyl sulfoxide-treated flaps) at 9.90 +/- 3.44 percent did not achieve statistically higher mean surviving areas than controls. A topical solution of oleic acid (10% by volume) caused a statistically significant increase in the survival of rat abdominal skin flaps relative to controls. Dimethyl sulfoxide and the two experimental drugs together did not increase the percentage of flap survival when given as a single 5-ml dose released from a surgical sponge at reperfusion for 1 hour and then daily for a total of 5 days. The reasons for the lack of response are unknown but may have included the technical difficulty of delivering an adequate dose of dimethyl sulfoxide topically and immiscibility between dimethyl sulfoxide and oleic acid. Further studies may be warranted.
Oscar K Hsu; Essam Gabr; Earl Steward; Heidi Chen; Mark R Kobayashi; Jay W Calvert; Michael J Sundine; Taline Kotchounian; Sanjay Dhar; Gregory R D Evans
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  113     ISSN:  0032-1052     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-07-15     Completed Date:  2004-07-29     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2048-54; discussion 2055-6     Citation Subset:  AIM; IM    
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MeSH Terms
Administration, Topical
Dermatologic Surgical Procedures
Dimethyl Sulfoxide / administration & dosage
Free Radical Scavengers / administration & dosage
Graft Survival / drug effects*
Oleic Acid / administration & dosage*,  pharmacology
Rats, Nude
Rats, Sprague-Dawley
Skin Absorption
Surgical Flaps*
Reg. No./Substance:
0/Free Radical Scavengers; 2UMI9U37CP/Oleic Acid; YOW8V9698H/Dimethyl Sulfoxide
Comment In:
Plast Reconstr Surg. 2005 Jun;115(7):2145; author reply 2145-6   [PMID:  15923878 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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