Skip to main content
Top
Published in: Aesthetic Plastic Surgery 5/2013

01-10-2013 | Original Article

Pre- and/or Postsurgical Administration of Estradiol Benzoate Increases Skin Flap Viability in Female Rats

Authors: Tomáš Vasilenko, Martin Slezák, Martin Novotný, Ivan Kováč, Ján Ďurkáč, Iveta Tomková, Norbert Torma, Andrej Vrzgula, Ľudovít Lenhardt, Mikukáš Levkut, Peter Gál

Published in: Aesthetic Plastic Surgery | Issue 5/2013

Login to get access

Abstract

Background

It has been shown that estrogens have a protective effect with regard to tissue ischemia. Therefore, in this macroscopic and histological investigation, the effect of estradiol benzoate on skin flap viability was studied in sham-operated and ovariectomized Sprague-Dawley rats.

Methods

Three months prior to flap surgery a group of rats underwent ovariectomy, while the remaining animals underwent a sham operation. Subsequently, all rats had a 2 × 8-cm skin flap created on the dorsum. Rats were randomly divided into estradiol- or saline-treated groups. Treatment started either on the day of flap excision or 3 days prior to the surgery.

Results

Our results showed that administration of estradiol benzoate prior to and after flap surgery significantly decreases skin flap necrosis in both sham-operated and ovariectomized rats, with the highest survival rate in animals where treatment started 3 days prior to flap surgery.

Conclusion

In conclusion, the observed protective effect of estradiol on skin flap viability could potentially be applied to plastic and reconstructive surgery in postmenopausal women. Nevertheless, further research is needed to explain the exact underlying mechanism and to find the optimal treatment protocol for human clinical practice.

Level of Evidence I

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literature
1.
go back to reference Pinfildi CE, Liebano RE, Hochman BS, Ferreira LM (2005) Helium-neon laser in viability of random skin flap in rats. Lasers Surg Med 37:74–77PubMedCrossRef Pinfildi CE, Liebano RE, Hochman BS, Ferreira LM (2005) Helium-neon laser in viability of random skin flap in rats. Lasers Surg Med 37:74–77PubMedCrossRef
2.
go back to reference Kryger Z, Zhang F, Dogan T, Cheng C, Lineaweaver WC, Buncke HJ (2000) The effects of VEGF on survival of a random flap in the rat: examination of various routes of administration. Br J Plast Surg 53:234–239PubMedCrossRef Kryger Z, Zhang F, Dogan T, Cheng C, Lineaweaver WC, Buncke HJ (2000) The effects of VEGF on survival of a random flap in the rat: examination of various routes of administration. Br J Plast Surg 53:234–239PubMedCrossRef
3.
go back to reference Holzbach T, Taskov C, Henke J, Busch R, Gänsbacher B, Biemer E, Giunta RE (2005) Evaluation of perfusion in skin flaps by laser-induced indocyanine green fluorescence. Handchir Mikrochir Plast Chir 37:396–402PubMedCrossRef Holzbach T, Taskov C, Henke J, Busch R, Gänsbacher B, Biemer E, Giunta RE (2005) Evaluation of perfusion in skin flaps by laser-induced indocyanine green fluorescence. Handchir Mikrochir Plast Chir 37:396–402PubMedCrossRef
4.
go back to reference Mokrý M, Gál P, Harakalová M, Hutnanová Z, Kusnír J, Mozes S, Sabo J (2007) Experimental study on predicting skin flap necrosis by fluorescence in the FAD and NADH bands during surgery. Photochem Photobiol 83:1193–1196PubMedCrossRef Mokrý M, Gál P, Harakalová M, Hutnanová Z, Kusnír J, Mozes S, Sabo J (2007) Experimental study on predicting skin flap necrosis by fluorescence in the FAD and NADH bands during surgery. Photochem Photobiol 83:1193–1196PubMedCrossRef
5.
go back to reference Gümüş N, Odemiş Y, Yılmaz S, Tuncer E (2012) Effect of topically applied minoxidil on the survival of rat dorsal skin flap. Aesthetic Plast Surg 36:1382–1386PubMedCrossRef Gümüş N, Odemiş Y, Yılmaz S, Tuncer E (2012) Effect of topically applied minoxidil on the survival of rat dorsal skin flap. Aesthetic Plast Surg 36:1382–1386PubMedCrossRef
6.
go back to reference Bailet JW, Hoffman LF, Trachy RE, Weymuller EA Jr (1994) The effect of nifedipine on skin flap survival in rats. Laryngoscope 104:253–258PubMed Bailet JW, Hoffman LF, Trachy RE, Weymuller EA Jr (1994) The effect of nifedipine on skin flap survival in rats. Laryngoscope 104:253–258PubMed
7.
go back to reference Armstrong M Jr, Kunar DR, Cummings CW (1993) Effect of pentoxifylline on myocutaneous flap viability in pigs. Otolaryngol Head Neck Surg 109:668–675PubMed Armstrong M Jr, Kunar DR, Cummings CW (1993) Effect of pentoxifylline on myocutaneous flap viability in pigs. Otolaryngol Head Neck Surg 109:668–675PubMed
8.
go back to reference Freitas FA, Piccinato CE, Cherri J, Marchesan WG (2010) Effects of pentoxyfilline and heparin on reperfusion injury island skin flaps in rats exposed to tobacco. J Surg Res 164:139–145PubMedCrossRef Freitas FA, Piccinato CE, Cherri J, Marchesan WG (2010) Effects of pentoxyfilline and heparin on reperfusion injury island skin flaps in rats exposed to tobacco. J Surg Res 164:139–145PubMedCrossRef
9.
go back to reference Ulusoy MG, Uysal A, Kocer U, Karaaslan O, Cuzdan SS, Ayyildiz A, Ustun H (2005) Improved flap viability with sitespecific delivery of sildenafil citrate using fibrin glue. Ann Plast Surg 55:292–296PubMedCrossRef Ulusoy MG, Uysal A, Kocer U, Karaaslan O, Cuzdan SS, Ayyildiz A, Ustun H (2005) Improved flap viability with sitespecific delivery of sildenafil citrate using fibrin glue. Ann Plast Surg 55:292–296PubMedCrossRef
10.
go back to reference Richards L, Lineaweaver WC, Stile F, Zhang J, Zhang F (2003) Effect of hyperbaric oxygen therapy on the tubed pedicle flap survival in a rat model. Ann Plast Surg 50:51–56PubMedCrossRef Richards L, Lineaweaver WC, Stile F, Zhang J, Zhang F (2003) Effect of hyperbaric oxygen therapy on the tubed pedicle flap survival in a rat model. Ann Plast Surg 50:51–56PubMedCrossRef
11.
go back to reference Findikcioglu F, Findikcioglu K, Yavuzer R, Lortlar N, Atabay K (2012) Effect of preoperative subcutaneous platelet-rich plasma and fibrin glue application on skin flap survival. Aesthetic Plast Surg 36:1246–1253PubMedCrossRef Findikcioglu F, Findikcioglu K, Yavuzer R, Lortlar N, Atabay K (2012) Effect of preoperative subcutaneous platelet-rich plasma and fibrin glue application on skin flap survival. Aesthetic Plast Surg 36:1246–1253PubMedCrossRef
12.
go back to reference Takikawa M, Sumi Y, Ishihara M, Kishimoto S, Nakamura S, Yanagibayashi S, Hattori H, Azuma R, Yamamoto N, Kiyosawa T (2011) PRP&F/P MPs improved survival of dorsal paired pedicle skin flaps in rats. J Surg Res 170:e189–e196PubMedCrossRef Takikawa M, Sumi Y, Ishihara M, Kishimoto S, Nakamura S, Yanagibayashi S, Hattori H, Azuma R, Yamamoto N, Kiyosawa T (2011) PRP&F/P MPs improved survival of dorsal paired pedicle skin flaps in rats. J Surg Res 170:e189–e196PubMedCrossRef
13.
go back to reference Costa MS, Pinfildi CE, Gomes HC, Liebano RE, Arias VE, Silveira TS, Ferreira LM (2010) Effect of low-level laser therapy with output power of 30 mW and 60 mW in the viability of a random skin flap. Photomed Laser Surg 28:57–61PubMedCrossRef Costa MS, Pinfildi CE, Gomes HC, Liebano RE, Arias VE, Silveira TS, Ferreira LM (2010) Effect of low-level laser therapy with output power of 30 mW and 60 mW in the viability of a random skin flap. Photomed Laser Surg 28:57–61PubMedCrossRef
14.
go back to reference Emmerson E, Hardman MJ (2012) The role of estrogen deficiency in skin ageing and wound healing. Biogerontology 13:3–20PubMedCrossRef Emmerson E, Hardman MJ (2012) The role of estrogen deficiency in skin ageing and wound healing. Biogerontology 13:3–20PubMedCrossRef
15.
go back to reference Kuiper GG, Carlsson B, Grandien K, Enmark E, Häggblad J, Nilsson S, Gustafsson JA (2010) Comparison of the ligand binding specificity and transcript tissue distribution of estrogen receptors alpha and beta. Endocrinology 138:863–870CrossRef Kuiper GG, Carlsson B, Grandien K, Enmark E, Häggblad J, Nilsson S, Gustafsson JA (2010) Comparison of the ligand binding specificity and transcript tissue distribution of estrogen receptors alpha and beta. Endocrinology 138:863–870CrossRef
16.
go back to reference Mizukami Y (2010) In vivo functions of GPR30/GPER-1, a membrane receptor for estrogen: from discovery to functions in vivo. Endocr J 57:101–107PubMedCrossRef Mizukami Y (2010) In vivo functions of GPR30/GPER-1, a membrane receptor for estrogen: from discovery to functions in vivo. Endocr J 57:101–107PubMedCrossRef
17.
go back to reference Toutain CE, Brouchet L, Raymond-Letron I, Vicendo P, Bergès H, Favre J, Fouque MJ, Krust A, Schmitt AM, Chambon P, Gourdy P, Arnal JF, Lenfant F (2009) Prevention of skin flap necrosis by estradiol involves reperfusion of a protected vascular network. Circ Res 104:245–254PubMedCrossRef Toutain CE, Brouchet L, Raymond-Letron I, Vicendo P, Bergès H, Favre J, Fouque MJ, Krust A, Schmitt AM, Chambon P, Gourdy P, Arnal JF, Lenfant F (2009) Prevention of skin flap necrosis by estradiol involves reperfusion of a protected vascular network. Circ Res 104:245–254PubMedCrossRef
18.
go back to reference van Boxtel R, Cuppen E (2010) Rat traps: filling the toolbox for manipulating the rat genome. Genome Biol 11:217PubMed van Boxtel R, Cuppen E (2010) Rat traps: filling the toolbox for manipulating the rat genome. Genome Biol 11:217PubMed
19.
go back to reference Xu R, Ge J, Lei Y, Lu X (2009) Improvement effect of estrogen on flap reperfusion injury and blood supply. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 23:964–968PubMed Xu R, Ge J, Lei Y, Lu X (2009) Improvement effect of estrogen on flap reperfusion injury and blood supply. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 23:964–968PubMed
20.
go back to reference Spanholtz TA, Theodorou P, Holzbach T, Wutzler S, Giunta RE, Machens HG (2011) Vascular endothelial growth factor (VEGF165) plus basic fibroblast growth factor (bFGF) producing cells induce a mature and stable vascular network–a future therapy for ischemically challenged tissue. J Surg Res 171:329–338PubMedCrossRef Spanholtz TA, Theodorou P, Holzbach T, Wutzler S, Giunta RE, Machens HG (2011) Vascular endothelial growth factor (VEGF165) plus basic fibroblast growth factor (bFGF) producing cells induce a mature and stable vascular network–a future therapy for ischemically challenged tissue. J Surg Res 171:329–338PubMedCrossRef
21.
go back to reference Huang N, Ashrafpour H, Levine RH, Forrest CR, Neligan PC, Lipa JE, Pang CY (2012) Vasorelaxation effect and mechanism of action of vascular endothelial growth factor-165 in isolated perfused human skin flaps. J Surg Res 172:177–186PubMedCrossRef Huang N, Ashrafpour H, Levine RH, Forrest CR, Neligan PC, Lipa JE, Pang CY (2012) Vasorelaxation effect and mechanism of action of vascular endothelial growth factor-165 in isolated perfused human skin flaps. J Surg Res 172:177–186PubMedCrossRef
22.
go back to reference Lin J, Steenbergen C, Murphy E, Sun J (2009) Estrogen receptor-beta activation results in S-nitrosylation of proteins involved in cardioprotection. Circulation 120:245–254PubMedCrossRef Lin J, Steenbergen C, Murphy E, Sun J (2009) Estrogen receptor-beta activation results in S-nitrosylation of proteins involved in cardioprotection. Circulation 120:245–254PubMedCrossRef
23.
go back to reference Etgen AM, Jover-Mengual T, Zukin RS (2011) Neuroprotective actions of estradiol and novel estrogen analogs in ischemia: translational implications. Front Neuroendocrinol. 32:336–352PubMedCrossRef Etgen AM, Jover-Mengual T, Zukin RS (2011) Neuroprotective actions of estradiol and novel estrogen analogs in ischemia: translational implications. Front Neuroendocrinol. 32:336–352PubMedCrossRef
24.
go back to reference Suzuki S, Brown CM, Wise PM (2009) Neuroprotective effects of estrogens following ischemic stroke. Front Neuroendocrinol 30:201–211PubMedCrossRef Suzuki S, Brown CM, Wise PM (2009) Neuroprotective effects of estrogens following ischemic stroke. Front Neuroendocrinol 30:201–211PubMedCrossRef
25.
go back to reference Lebesgue D, Chevaleyre V, Zukin RS, Etgen AM (2009) Estradiol rescues neurons from global ischemia-induced cell death: multiple cellular pathways of neuroprotection. Steroids 74:555–561PubMedCrossRef Lebesgue D, Chevaleyre V, Zukin RS, Etgen AM (2009) Estradiol rescues neurons from global ischemia-induced cell death: multiple cellular pathways of neuroprotection. Steroids 74:555–561PubMedCrossRef
26.
go back to reference Gál P, Toporcer T, Vidinský B, Mokrý M, Grendel T, Novotný M, Sokolský J, Bobrov N, Toporcerová S, Sabo J, Mozes S (2008) Postsurgical administration of estradiol benzoate decreases tensile strength of healing skin wounds in ovariectomized rats. J Surg Res 147:117–222PubMedCrossRef Gál P, Toporcer T, Vidinský B, Mokrý M, Grendel T, Novotný M, Sokolský J, Bobrov N, Toporcerová S, Sabo J, Mozes S (2008) Postsurgical administration of estradiol benzoate decreases tensile strength of healing skin wounds in ovariectomized rats. J Surg Res 147:117–222PubMedCrossRef
27.
go back to reference Novotný M, Vasilenko T, Varinská L, Smetana K Jr, Szabo P, Sarišský M, Dvořánková B, Mojžiš J, Bobrov N, Toporcerová S, Sabol F, Matthews BJ, Gál P (2011) ER-α agonist induces conversion of fibroblasts into myofibroblasts, while ER-β agonist increases ECM production and wound tensile strength of healing skin wounds in ovariectomised rats. Exp Dermatol 20:703–708PubMedCrossRef Novotný M, Vasilenko T, Varinská L, Smetana K Jr, Szabo P, Sarišský M, Dvořánková B, Mojžiš J, Bobrov N, Toporcerová S, Sabol F, Matthews BJ, Gál P (2011) ER-α agonist induces conversion of fibroblasts into myofibroblasts, while ER-β agonist increases ECM production and wound tensile strength of healing skin wounds in ovariectomised rats. Exp Dermatol 20:703–708PubMedCrossRef
Metadata
Title
Pre- and/or Postsurgical Administration of Estradiol Benzoate Increases Skin Flap Viability in Female Rats
Authors
Tomáš Vasilenko
Martin Slezák
Martin Novotný
Ivan Kováč
Ján Ďurkáč
Iveta Tomková
Norbert Torma
Andrej Vrzgula
Ľudovít Lenhardt
Mikukáš Levkut
Peter Gál
Publication date
01-10-2013
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 5/2013
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-013-0151-z

Other articles of this Issue 5/2013

Aesthetic Plastic Surgery 5/2013 Go to the issue