Effect of topical nitroglycerin on neoangiogenesis and pedicle-independent viability in a rat dorsal skin flap model

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Interpolated flaps are frequently used in reconstructive surgery when free tissue transfer is not feasible, but they require staged procedures due to pedicle dependence. Flap autonomization, the process by which transferred tissue develops new vascular connections and survives independently of its pedicle, is essential before division. Although methods such as delay techniques, hyperbaric oxygen (HBO), vascular endothelial growth factor (VEGF), and stem cell therapies have been tested to enhance angiogenesis, the effect of topical nitroglycerin (NTG), a nitric oxide (NO) donor with vasodilatory, anti-inflammatory, and angiogenic properties, has not been investigated. This study aimed to evaluate the effect of topical NTG on neoangiogenesis and flap autonomization in a rat dorsal skin flap model. Sixty Wistar-Albino rats were divided into five groups (n = 12). A 3×3 cm dorsal flap with a caudal pedicle was elevated in all animals. In Groups 1-3, pedicles were transected on day 5: Group 1 received vaseline, Group 2 received NTG for 5 days then vaseline, and Group 3 received NTG continuously. Groups 4 and 5 were sacrificed on day 5 to assess early angiogenesis after vaseline or NTG. Flap survival was analyzed with ImageJ, angiogenesis with VEGF, CD34, and CD105 staining, and histology with Hematoxylin and Eosin (H&E) and Masson's Trichrome. Flap survival was significantly greater

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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