Department of Hand and Plastic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, The Second School of Medicine, Wenzhou Medical University, Wenzhou, China.
Phytother Res. 2024 Feb;38(2):527-538. doi: 10.1002/ptr.8058. Epub 2023 Nov 1.
Flaps are mainly used for wound repair. However, postoperative ischemic necrosis of the distal flap is a major problem, which needs to be addressed urgently. We evaluated whether tetrandrine, a compound found in traditional Chinese medicine, can prolong the survival rate of random skin flaps. Thirty-six rats were randomly divided into control, low-dose tetrandrine (25 mg/kg/day), and high-dose tetrandrine (60 mg/kg/day) groups. On postoperative Day 7, the flap survival and average survival area were determined. After the rats were sacrificed, the levels of angiogenesis, apoptosis, and inflammation in the flap tissue were detected with immunology and molecular biology analyses. Tetrandrine increased vascular endothelial growth factor and Bcl-2 expression, in turn promoting angiogenesis and anti-apoptotic processes, respectively. Additionally, tetrandrine decreased the expression of Bax, which is associated with the induction of apoptosis, and also decreased inflammation in the flap tissue. Tetrandrine improved the survival rate of random flaps by promoting angiogenesis, inhibiting apoptosis, and reducing inflammation in the flap tissue through the modulation of the PI3K/AKT signaling pathway.
皮瓣主要用于创伤修复。然而，术后皮瓣远端缺血性坏死是一个亟待解决的问题。我们评估了中药汉防己甲素是否能提高随意皮瓣的成活率。36 只大鼠随机分为对照组、低剂量汉防己甲素（25mg/kg/天）组和高剂量汉防己甲素（60mg/kg/天）组。术后第 7 天，测定皮瓣成活率和平均存活面积。处死大鼠后，采用免疫学法和分子生物学分析法检测皮瓣组织中的血管生成、细胞凋亡和炎症水平。汉防己甲素增加了血管内皮生长因子和 Bcl-2 的表达，分别促进了血管生成和抗细胞凋亡过程。此外，汉防己甲素降低了 Bax 的表达，Bax 与细胞凋亡的诱导有关，同时还降低了皮瓣组织中的炎症反应。汉防己甲素通过调节 PI3K/AKT 信号通路，促进皮瓣组织的血管生成、抑制细胞凋亡和减轻炎症反应，从而提高随意皮瓣的成活率。
