Chlorogenic Acid Enhances Abdominal Skin Flap Survival Based on Epigastric Artery in Nondiabetic and Diabetic Rats.

Previous studies showed that chlorogenic acid (CGA) accelerates wound healing via its antioxidant activity. We aimed to investigate the effect of CGA in an experimental epigastric abdominal skin flap model in nondiabetic and diabetic rats. Rats were firstly divided into 2 groups: nondiabetic and diabetic. Diabetes was induced by streptozotocin. Then, 4 subgroups were created for each group: vehicle as well as 0.2 mg/0.5 mL, 1 mg/0.5 mL, and 5 mg/0.5 mL CGA treatments. Right epigastric artery-based abdominal skin flaps were elevated and sutured back into their original position. Chlorogenic acid or vehicle was injected once into the femoral arteries by leaving the epigastric artery as the single artery feeding the flaps during the injection. On postoperative day 7, flap survivals were evaluated, and the rats were killed. Distal flap tissues were collected for histopathological and biochemical assays. Chlorogenic acid showed greater flap survival in both nondiabetic and diabetic rats. Capillary density was increased, and necrosis was reduced in the CGA-treated rats. Chlorogenic acid decreased malondialdehyde levels as well as increased reduced glutathione and superoxide dismutase levels in the flap tissues. This study showed that CGA significantly improved flap survival by its antioxidant activities with intra-arterial local injections.

In vivo systemic chlorogenic acid therapy under diabetic conditions: Wound healing effects and cytotoxicity/genotoxicity profile.

Oxidative stress occurs following the impairment of pro-oxidant/antioxidant balance in chronic wounds and leads to harmful delays in healing progress. A fine balance between oxidative stress and endogenous antioxidant defense system may be beneficial for wound healing under redox control. This study tested the hypothesis that oxidative stress in wound area can be controlled with systemic antioxidant therapy and therefore wound healing can be accelerated. We used chlorogenic acid (CGA), a dietary antioxidant, in experimental diabetic wounds that are characterized by delayed healing. Additionally, we aimed to understand possible side effects of CGA on pivotal organs and bone marrow during therapy. Wounds were created on backs of streptozotocin-induced diabetic rats. CGA (50 mg/kg/day) was injected intraperitoneally. Animals were sacrificed on different days. Biochemical and histopathological examinations were performed. Side effects of chronic antioxidant treatment were tested. CGA accelerated wound healing, enhanced hydroxyproline content, decreased malondialdehyde/nitric oxide levels, elevated reduced-glutathione, and did not affect superoxide dismutase/catalase levels in wound bed. While CGA induced side effects such as cyto/genotoxicity, 15 days of treatment attenuated blood glucose levels. CGA decreased lipid peroxidation levels of main organs. This study provides a better understanding for antioxidant intake on diabetic wound repair and possible pro-oxidative effects.

Pharmacologic overview of systemic chlorogenic acid therapy on experimental wound healing.

Chlorogenic acid (CGA) is a well-known natural antioxidant in human diet. To understand the effects of CGA on wound healing by enhancing antioxidant defense in the body, the present study sought to investigate the potential role of systemic CGA therapy on wound healing and oxidative stress markers of the skin. We also aimed to understand whether chronic CGA treatment has side effects on pivotal organs or rat bone marrow during therapy. Full-thickness experimental wounds were created on the backs of rats. CGA (25, 50, 100, 200 mg/kg) or vehicle was administered intraperitoneally for 15 days. All rats were sacrificed on the 16th day. Biochemical, histopathological, and immunohistochemical examinations were performed. Possible side effects were also investigated. The results suggested that CGA accelerated wound healing in a dose-dependent manner. CGA enhanced hydroxyproline content, decreased malondialdehyde and nitric oxide levels. and elevated reduced glutathione, superoxide dismutase, and catalase levels in wound tissues. Epithelialization, angiogenesis, fibroblast proliferation, and collagen formation increased by CGA while polymorph nuclear leukocytes infiltration decreased. CGA modulated matrix metalloproteinase-9 and tissue inhibitor-2 expression in biopsies. Otherwise, high dose of CGA increased lipid peroxidation of liver and kidney without affecting the heart and muscle samples. Chronic CGA increased micronuclei formation and induced cytotoxicity in the bone marrow. In conclusion, systemic CGA has beneficial effects in improving wound repair. Antioxidant, free radical scavenger, angiogenesis, and anti-inflammatory effects of CGA may ameliorate wound healing. High dose of CGA may induce side effects. In light of these observations, CGA supplementation or dietary CGA may have benefit on wound healing.

Preventing Flap Necrosis With Adrenomedullin and Glucagon-like Peptide-1.

UNLABELLED:  Many factors are known to play a role in flap necrosis, such as inadequate blood flow and disturbed venous drainage, which lead to decreased flap nutrition and necrosis. The aim of this study was to determine whether adrenomedullin (ADM) and glucagon-like Peptide-1 (GLP-1) administered at various doses directly to the superficial inferior epigastric artery (SIEA) had an effect on the normal healing process of flap tissue. METHODS: Under 3% isoflurane anesthesia, the rats were put in the dorsal decubitus position before the surgery. A cutaneous flap 8 cm x 3 cm in size was marked on the abdominal wall, divided into four equal sections, and marked from 1 to 4 (proximal to distal). A laser Doppler flowmeter was used to measure the blood supply of each area in the flap tissue. On the seventh postoperative day, an image of the final condition of the flap was obtained with a 5-megapixel camera; the rats were sacrificed afterward. RESULTS: Groups treated with ADM or GLP-1 showed a statistically significant increase in the blood flow of the four separate regions compared to the saline group. The percent necrosis area decreased in a statistically significant manner in the groups treated with ADM and GLP-I. CONCLUSION: The authors believe that both peptides play an important role in the normal flap recovery process. .

Nasal shapes and related differences in nostril forms: a morphometric analysis in young adults.

Being aware of the morphologic differences in the nasal anatomy between men and women during the cosmetic rhinoplasty is essential because feminization of a male nose is not a very rare complication. Although there is no difference in the techniques of male and female rhinoplasty, the anthropometric differences have to be considered. This morphometric study evaluated the nasal shapes in both sexes and the related differences in the nostril forms. The nostril forms were separated into 4 main groups such as teardrop, heart shaped, round, and triangular. In this landmark-based morphometric study, significant relations of nostril forms to the nasal shape, frontonasal, and nasolabial angles were found. The results of this study should make us think about these relations of nostril forms to the nasal shapes and should be a basement for further clinical studies enhancing the plans of the corrective surgery.