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Zheng YH, Yin LQ, Xu HK, Gong X. Non-invasive physical therapy as salvage measure for ischemic skin flap: A literature review. World J Clin Cases 2021; 9:3227-3237. [PMID: 34002132 PMCID: PMC8107891 DOI: 10.12998/wjcc.v9.i14.3227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/26/2021] [Accepted: 03/10/2021] [Indexed: 02/06/2023] Open
Abstract
This review focuses on the available evidence regarding the molecular mechanisms and treatment potential of several non-surgical physical therapies for managing flap ischemia to propose a non-invasive, economical, and simple treatment to improve flap survival. A review of the literature was conducted on the topics of various non-invasive methods for the treatment of ischemic necrosis of the distal end of the flap between 1988 and 2019. A total of 52 published studies were reviewed on the applications of hyperbaric oxygen therapy, electrical stimulation therapy, heat stress pretreatment, phototherapy, and vibration therapy to manage skin flap necrosis. The underlying molecular mechanisms of these physical therapies on revitalizing the dying skin flaps were discussed and preliminary clinical uses of these therapies to salvage the necrotic skin flaps were pooled and summarized for clarifying the safety and feasibility of these methods. Various physical therapy regimens have been ushered to manage necrotic development in cutaneous flaps. With the refinement of these new technologies and enhancement of related basic science research on vascular revitalization, the prevention and treatment of flap ischemia will enter a new era.
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Affiliation(s)
- Yin-Hua Zheng
- Department of Hand and Foot Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Li-Quan Yin
- Department of Rehabilitation Medicine, The Third Hospital of Jilin University, Changchun 130033, Jilin Province, China
| | - Hai-Kun Xu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
| | - Xu Gong
- Department of Hand and Foot Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
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Ashrafi M, Alonso-Rasgado T, Baguneid M, Bayat A. The efficacy of electrical stimulation in experimentally induced cutaneous wounds in animals. Vet Dermatol 2016; 27:235-e57. [DOI: 10.1111/vde.12328] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Mohammed Ashrafi
- Plastic and Reconstructive Surgery Research; Centre for Dermatological Research; Institute of Inflammation and Repair; University of Manchester; Oxford Road Manchester M13 9PT UK
| | - Teresa Alonso-Rasgado
- Bioengineering Group; School of Materials; University of Manchester; Oxford Road Manchester M13 9PT UK
| | - Mohamed Baguneid
- Wythenshawe Hospital; University Hospital South Manchester NHS Foundation Trust; Southmoor Road Manchester M23 9LT UK
| | - Ardeshir Bayat
- Plastic and Reconstructive Surgery Research; Centre for Dermatological Research; Institute of Inflammation and Repair; University of Manchester; Oxford Road Manchester M13 9PT UK
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Torkaman G. Electrical Stimulation of Wound Healing: A Review of Animal Experimental Evidence. Adv Wound Care (New Rochelle) 2014; 3:202-218. [PMID: 24761359 DOI: 10.1089/wound.2012.0409] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 04/14/2013] [Indexed: 11/12/2022] Open
Abstract
Significance: Electrical stimulation (ES) is a therapeutic intervention that may help specialists facilitate wound healing rates. The purpose of this section is to compile the available animal research regarding the effectiveness of ES on the injury potential, healing rate, cellular and molecular proliferation, mechanical properties, and survival rate of skin flaps. Recent Advances: Regardless of the type of ES current and polarity used, most of the animal experimental evidence suggests that application of ES can facilitate wound healing. However, treatment time should be sufficiently long to attain good mechanical strength of regenerated tissue, because tensile strength is not consistent with augmented collagen deposition. ES improves the survival rate and skin blood flow of animal flaps, but clinical studies are needed to substantiate the findings from these animal experiments. Critical Issues: Impaired or delayed healing is a major clinical problem that can lead to wound chronicity. ES with various strategies has been used to facilitate the healing process, but many aspects remain controversial. Despite much research, no consensus exists regarding the detailed effects of ES on wound healing. Nevertheless, ES has been approved by the Center for Medicare and Medicine Services for reimbursement of the treatment of some chronic ulcers. Future Directions: Exogenous ES may promote the directional migration of cells and signaling molecules via electrotaxis; however, its underlying mechanism is still poorly understood. Future studies that further elucidate the mechanisms regulating electrotaxis will be necessary to optimize the use of ES in different wound states.
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Affiliation(s)
- Giti Torkaman
- Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Perez Machado AF, Santana EF, Tacani PM, Liebano RE. The effects of transcutaneous electrical nerve stimulation on tissue repair: A literature review. THE CANADIAN JOURNAL OF PLASTIC SURGERY = JOURNAL CANADIEN DE CHIRURGIE PLASTIQUE 2012. [DOI: 10.1177/229255031202000415] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Transcutaneous electrical nerve stimulation (TENS) consists of a generic application of low-frequency, pulsed electrical currents transmitted by electrodes through the skin surface. It is a therapeutic modality that is nonpharmacological, noninvasive, inexpensive, easy to use and widely applied in clinical practice. Objective To narratively review the scientific evidence of the effects of TENS on tissue repair with respect to wound healing, skin flap viability and tendinous repair. Methods The study was conducted using the MEDLINE, Lilacs and Scielo databases, without limit to the period of publication, and was completed in November 2011. Inclusion criteria were randomized or nonrandomized, controlled or noncontrolled clinical trials, and experimental trials involving rats subjected to TENS for tissue repair. Results Thirty articles on tissue repair were found and, among these, 14 reported on wound healing, 14 reported on skin flaps and two analyzed tedinous repair. Discussion It was suggested that TENS stimulates skin wound healing and tendon repair, as well as the viability of random skin flaps. Such effects may be due to the release of substance P and calcitonin gene-related peptide, which would increase blood flow and, consequently, hasten the events leading to tissue repair. Conclusions Based on the scientific evidence regarding the effects of TENS on tissue repair, the findings of the present literature review were inconclusive because data from the randomized controlled clinical trials were insufficient to confirm such effects.
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Lima LP, de Oliveira Albuquerque A, de Lima Silva JJ, Medeiros FDC, de Vasconcelos PRL, Guimarães SB. Electroacupuncture attenuates oxidative stress in random skin flaps in rats. Aesthetic Plast Surg 2012; 36:1230-5. [PMID: 22678136 DOI: 10.1007/s00266-012-9926-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 05/15/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Skin flaps may be damaged by free radicals produced during blood reflow and oxygen return to ischemic tissues. Considering that published studies have demonstrated the effects of manual acupuncture (MA) and electroacupuncture (EA) in attenuating the oxidative stress in different tissues and organs, this study aimed to investigate the possible protective effects of MA and EA in randomized skin flaps in rats. METHODS Thirty-two rats were subjected to dorsal skin flap (8 × 2.5 cm) construction and randomly divided into four groups of eight rats each: G1, surgical trauma; G2, MA; G3, EA 3 Hz; and G4, EA 100 Hz. All rats were anesthetized with ketamine (90 mg/kg) + xylazine (10 mg/kg) intraperitoneally on days 1, 3, and 7. MA (G2) and EA (G3/G4) were applied on days 3 and 7 of the experiment. G3 and G4 rats were treated with EA 3 and 100 Hz, respectively. Needles were inserted in GV-14 (Dazhui), GV-2 (Yaoshu), and L-13 (Zhangmen) acupoints and retained for 30 min. Blood and skin samples were collected at the end of the last procedure. The ANOVA/Dunnett test was used for group comparison. Values of p < 0.05 were considered significant. RESULTS Skin myeloperoxidase (MPO) activity decreased significantly in G2, G3, and G4 rats. Plasma and skin levels of reduced glutathione (GSH) increased significantly in G3 and G4 rats (p < 0.001) compared with G1 control. Malondialdehyde (MDA) plasma and skin levels increased significantly in G4 compared with G1 rats. CONCLUSIONS MA/EA decreased MPO activity in the graft, consistent with attenuated inflammation, and increased plasma and tissue GSH, indicative of reduced systemic and local oxidative stress. EA at 100 Hz enhances lipid peroxidation in plasma and skin of rats subjected to surgical stress. LEVEL OF EVIDENCE II This journal requires that authors assign a level of evidence to each article.
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Prado RP, Garcia SB, Thomazini JA, Piccinato CE. Effects of 830 and 670 nm Laser on Viability of Random Skin Flap in Rats. Photomed Laser Surg 2012; 30:418-24. [DOI: 10.1089/pho.2011.3042] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Rodrigo P Prado
- Department of Physiotherapy, Federal University of Goias, Campus Jataí, Goias, Brazil
| | - Sergio Britto Garcia
- Department of Pathology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - José A Thomazini
- Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Carlos E Piccinato
- Department of Surgery and Anatomy, Division of Vascular and Endovascular Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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What is better in TRAM flap survival: LLLT single or multi-irradiation? Lasers Med Sci 2012; 28:755-61. [DOI: 10.1007/s10103-012-1130-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 05/31/2012] [Indexed: 10/28/2022]
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das Neves LMS, Marcolino AM, Prado RP, De Souza Ribeiro T, Pinfildi CE, Thomazini JA. Low-Level Laser Therapy on the Viability of Skin Flap in Rats Subjected to Deleterious Effect of Nicotine. Photomed Laser Surg 2011; 29:581-7. [DOI: 10.1089/pho.2010.2883] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Lais Mara Siqueira das Neves
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, University of São Paulo—FMRP/USP, Ribeirão Preto, Brazil
| | - Alexandre Marcio Marcolino
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, University of São Paulo—FMRP/USP, Ribeirão Preto, Brazil
| | | | - Tiago De Souza Ribeiro
- Department of Clinical Surgery, University of São Paulo—FMRP/USP, Ribeirão Preto. Brazil
| | | | - José Antônio Thomazini
- Department of Clinical Surgery, University of São Paulo—FMRP/USP, Ribeirão Preto, Brazil
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Neves LMSD, Marcolino AM, Prado RP, Thomazini JA. Laser 830nm na viabilidade do retalho cutâneo de ratos submetidos à nicotina. ACTA ORTOPEDICA BRASILEIRA 2011. [DOI: 10.1590/s1413-78522011000600004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Investigar os possíveis efeitos da laserterapia com laser diodo 830nm ao se contrapor a ação da nicotina na viabilidade do retalho cutâneo em ratos. MÉTODOS: Foram utilizados 16 ratos Wistar, distribuídos em 2 grupos de 8: Grupo 1- submetido à técnica cirúrgica, para obtenção dos retalhos cutâneos randômicos de base cranial, com injeção subcutânea de nicotina em uma dose de 2mg/Kg/dia, uma semana antes e uma semana após o procedimento cirúrgico e simulação da radiação laser; Grupo 2- similar ao grupo 1, cujos retalhos cutâneos randômicos de base cranial foram submetidos à irradiação do laser imediatamente após a cirurgia e nos 4 dias subsequentes. Após a eutanásia, as áreas de necrose e de tecido viável foram examinadas através do método de pesagem do Gabarito de Papel e pelo método semi-automático de análise de imagens (Mini-Mop®). RESULTADOS: Os resultados foram analisados estatisticamente através do teste ANOVA. Os valores de porcentagem de área de necrose através do método de análise mostraram uma diminuição da área de necrose no grupo 2 onde foi aplicado laser. CONCLUSÃO: O laser 830nm foi eficaz na melhora da viabilidade do retalho cutâneo em ratos submetido à ação da nicotina. Nível de evidência II: Estudos terapêuticos - Investigação dos resultados do tratamento.
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Tacani PM, Liebano RE, Pinfildi CE, Gomes HC, Arias VE, Ferreira LM. Mechanical stimulation improves survival in random-pattern skin flaps in rats. ULTRASOUND IN MEDICINE & BIOLOGY 2010; 36:2048-2056. [PMID: 20950928 DOI: 10.1016/j.ultrasmedbio.2010.07.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2009] [Revised: 06/29/2010] [Accepted: 07/26/2010] [Indexed: 05/30/2023]
Abstract
This was a study on the effects of 3-MHz ultrasound at 16- and 100-Hz pulse repetition frequencies on angiogenesis and viability of random-pattern skin flaps in rats. A cranially-based dorsal skin flap was raised in 60 EPM-Wistar rats, which were randomly divided into four groups: control, sham, 16-Hz and 100-Hz groups. The mean percentage of necrosis was as follows: control, 42% ± 13%; sham, 18% ± 13%; 16-Hz group, 13% ± 10%; and 100-Hz group, 15% ± 7%, with significant differences between the control and the other groups (p < 0.001). The mean vascular density was as follows: control, 5% ± 2%; sham, 7% ± 2%; 16-Hz group, 21% ± 4%; and 100-Hz group, 24% ± 10%, with significant differences between control and ultrasound groups, and between the sham and ultrasound groups (p < 0.001). Both ultrasound treatments (16- and 100-Hz PRFs) induced angiogenesis, and sham and ultrasound treatments improved viability of random-pattern skin flaps in rats.
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Affiliation(s)
- Pascale Mutti Tacani
- Graduate Program, Federal University of Sao Paulo School of Medicine (UNIFESP-EPM), Sao Paulo, Brazil.
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Prado R, Neves L, Marcolino A, Ribeiro T, Pinfildi C, Ferreira L, Thomazini J, Piccinato C. Effect of Low-Level Laser Therapy on Malondialdehyde Concentration in Random Cutaneous Flap Viability. Photomed Laser Surg 2010; 28:379-84. [DOI: 10.1089/pho.2009.2535] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Rodrigo Prado
- Department of Surgery and Anatomy, University of São Paulo–FMRP-USP, Ribeirão Preto, Brazil
| | - Lais Neves
- Department of Biomechanics, Medicine and Locomotor System Rehabilitation, University of São Paulo–FMRP-USP, Ribeirão Preto, Brazil
| | - Alexandre Marcolino
- Department of Biomechanics, Medicine and Locomotor System Rehabilitation, University of São Paulo–FMRP-USP, Ribeirão Preto, Brazil
| | - Tiago Ribeiro
- Department of Surgery and Anatomy, University of São Paulo–FMRP-USP, Ribeirão Preto, Brazil
| | - Carlos Pinfildi
- Department of Plastic Surgery, São Paulo Federal University, São Paulo, Brazil
| | - Lydia Ferreira
- Department of Plastic Surgery, São Paulo Federal University, São Paulo, Brazil
| | - José Thomazini
- Department of Surgery and Anatomy, University of São Paulo–FMRP-USP, Ribeirão Preto, Brazil
| | - Carlos Piccinato
- Department of Surgery and Anatomy, University of São Paulo–FMRP-USP, Ribeirão Preto, Brazil
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12
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Effect of Application Site of Low-Level Laser Therapy in Random Cutaneous Flap Viability in Rats. Photomed Laser Surg 2009; 27:411-6. [DOI: 10.1089/pho.2008.2320] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Pinfildi CE, Liebano RE, Hochman BS, Enokihara MM, Lippert R, Gobbato RC, Ferreira LM. Effect of Low-Level Laser Therapy on Mast Cells in Viability of the Transverse Rectus Abdominis Musculocutaneous Flap. Photomed Laser Surg 2009; 27:337-43. [DOI: 10.1089/pho.2008.2295] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Carlos Eduardo Pinfildi
- Department of Plastic Surgery and IMES-FAFICA, São Paulo Federal University (UNIFESP), São Paulo, SP, Brazil
| | - Richard Eloin Liebano
- Department of Plastic Surgery and UNICID, São Paulo Federal University (UNIFESP), São Paulo, SP, Brazil
| | - Bernardo S. Hochman
- Department of Plastic Surgery, São Paulo Federal University (UNIFESP), São Paulo, SP, Brazil
| | | | - Rodrigo Lippert
- Department of Plastic Surgery, São Paulo Federal University (UNIFESP), São Paulo, SP, Brazil
| | - Rafael Corrêa Gobbato
- Department of Plastic Surgery, São Paulo Federal University (UNIFESP), São Paulo, SP, Brazil
| | - Lydia Masako Ferreira
- Plastic Surgery, Division of Surgery Department and Post-Graduate Program in Plastic Surgery, São Paulo Federal University (UNIFESP), São Paulo, SP, Brazil
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Esteves Júnior I, Tacani PM, Liggieri VC, Ruggi BG, Ferreira LM, Liebano RE. Histamine iontophoresis on the viability of random skin flap in rats. Acta Cir Bras 2009; 24:48-51. [DOI: 10.1590/s0102-86502009000100010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2008] [Accepted: 11/11/2008] [Indexed: 11/21/2022] Open
Abstract
PURPOSE: To evaluate the effects of the histamine iontophoresis on the random skin flap viability in rats. METHODS: Sixty adult male Wistar rats were used. A cranially-based dorsal skin flap measuring 10 x 4 cm was raised and a plastic barrier was placed between the flap and its bed. After the surgical procedure, the animals were randomized into four groups (G1-G4) (n=15 each group) as follows: G1 (control) - sham electrical stimulation, G2 (electrical stimulation) - direct current electrical stimulation, G3 (histamine) - histamine and sham electrical stimulation and G4 (histamine iontophoresis) - transdermal iontophoresis of histamine. In all groups the procedures were performed immediately after the surgery and on the two subsequent days. The percentage of flap necrosis was measured on the seventh postoperative day. RESULTS: The mean and the respective standard deviation of the percentage of flap necrosis areas were as follows: G1 (control) - 47.87 ± 9.13%, G2 - 51.49 ± 8.19%, G3 - 46.33 ± 8.32% and G4 - 30.82 ± 11.25%. The G4 group presented a significantly smaller amount of flap necrosis when compared to the other groups (p<0.001). CONCLUSION: The topical administration of the histamine by iontophoresis was effective to increase the viability of the random skin flaps in rats.
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Affiliation(s)
| | - Pascale Mutti Tacani
- Federal University of Sao Paulo; University of Sao Caetano do Sul; Sao Camilo University Center, Brazil
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Effect of Eletroacupuncture on DU-14 (Dazhui), DU-2 (Yaoshu), and Liv-13 (Zhangmen) on the Survival of Wistar Ratsʼ Dorsal Skin Flaps. J Burn Care Res 2008; 29:353-7. [PMID: 18354293 DOI: 10.1097/bcr.0b013e31816679a6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Takaoka Y, Ohta M, Ito A, Takamatsu K, Sugano A, Funakoshi K, Takaoka N, Sato N, Yokozaki H, Arizono N, Goto S, Maeda E. Electroacupuncture suppresses myostatin gene expression: cell proliferative reaction in mouse skeletal muscle. Physiol Genomics 2007; 30:102-10. [PMID: 17341691 DOI: 10.1152/physiolgenomics.00057.2006] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Complementary and alternative medicine (CAM) may provide patients with an alternative to traditional medicine, but an assessment of its efficacy is required. One CAM method, electroacupuncture (EA) treatment, is a maneuver that utilizes stimulation of acupuncture needles with a low-frequency microcurrent. To study the effect of short-term EA, we evaluated the differential expression of genes induced by EA in mouse skeletal muscle for up to 24 h. We then used RT-PCR to confirm the expression patterns of six differentially expressed genes. Bioinformatics analysis of their transcription control regions showed that EA-inducible genes have numerous common binding motifs that are related to cell differentiation, cell proliferation, muscle repair, and hyperplasia. These results suggested that EA treatment may induce cell proliferation in skeletal muscle. To verify this possibility, we used EA to stimulate mouse skeletal muscle daily for up to 1 mo and examined the long-term effects. Immunohistochemical analysis showed that nuclei of muscle cells treated with EA for 1 mo, especially nuclei of satellite cells, reacted with anti-human PCNA. Also, expression of the gene encoding myostatin, which is a growth repressor in muscle satellite cells, was suppressed by daily EA treatment for 1 wk; EA treatment for 1 mo resulted in more marked suppression of the gene. These molecular findings constitute strong evidence that EA treatment suppresses myostatin expression, which leads to a satellite cell-related proliferative reaction and repair in skeletal muscle.
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Affiliation(s)
- Yutaka Takaoka
- Laboratory for Applied Genome Science, Clinical Genome Informatics Center, Kobe University Graduate School of Medicine, Kobe, Japan.
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Liebano RE, Abla LEF, Ferreira LM. Effect of high frequency transcutaneous electrical nerve stimulation on viability of random skin flap in rats. Acta Cir Bras 2006; 21:133-8. [PMID: 16751925 DOI: 10.1590/s0102-86502006000300003] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To determine the effect of high frequency Transcutaneous Electrical Nerve Stimulation (TENS) on viability of random skin flap in rats. METHODS The sample of this study was 75 Wistar rats. The skin flap measured 10 x 4 cm and a plastic barrier was interposed between the flap and donor site. After the operative procedure, animals of all groups were maintained anesthetized one more hour with electrodes positioned in the base of the flap and submitted to treatment according of their respective group. This procedure was repeated on the two subsequent days. G1: sham stimulation (control), G2: TENS (f = 80 Hz and I = 5 mA), G3: TENS (f = 80 Hz and I = 10 mA), G4: TENS (f = 80 Hz and I = 15 mA), G5: TENS (f = 80 Hz and I = 20 mA). RESULTS The average percentage of necrotic area was 43,11, 34,65, 49,44, 23,52, 45,10 in groups 1, 2, 3, 4 and 5 respectively. CONCLUSION The amplitude of 15 mA presented a lower necrotic area than control group and Transcutaneous Electrical Nerve Stimulation was efficient in increasing the random skin flap viability.
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Liebano RE, Ferreira LM, Sabino Neto M. Experimental model for transcutaneous electrical nerve stimulation on ischemic random skin flap in rats. Acta Cir Bras 2003. [DOI: 10.1590/s0102-86502003001100008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The objective of this paper was to develop an experimental model to be used in the study of Transcutaneous Electrical Nerve Stimulation (TENS) on viability of random skin flap in rats. The sample was 15 Wistar-EPM rats. The random skin flap measured 10x4 cm and a plastic barrier was placed between the flap and the donnor site. The animals were submited to TENS for 1 hour immediately after the surgery and on the two subsequent days. On the seventh postoperative day, the percentage of necrotic area was measured and calculated. The experimental model proved to be reliable to be used in the study of effects of Transcutaneous Electrical Nerve Stimulation in random skin flap in rats.
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Liebano RE, Ferreira LM, Neto MS. The effect of transcutaneous electrical nerve stimulation on the viability of random skin flaps in rats. THE CANADIAN JOURNAL OF PLASTIC SURGERY = JOURNAL CANADIEN DE CHIRURGIE PLASTIQUE 2002. [DOI: 10.1177/229255030201000407] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to determine the role of transcutaneous electrical nerve stimulation (TENS) in the viability of random skin flaps. In 30 Wistar-EPM rats, a random 10×4 cm skin flap was raised and a plastic barrier was interposed between the flap and its bed. Immediately after surgery and for two subsequent days, the rats in group 1 (the control group) were anesthetized for 1 h with the electrodes positioned in the base of the flap and without the administration of the electric stimulus. The rats in group 2 (the treatment group) were submitted to TENS for 1 h immediately after the surgery and for two subsequent days. The percentage of necrotic area (averages of 43.11% in the rats in group 1 and 23.52% in the rats in group 2) was calculated on the seventh postoperative day in both groups. Statistical analysis proved that TENS was more efficient in increasing random skin flap viability than was the method used in the control group.
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Affiliation(s)
- Richard Eloin Liebano
- Plastic Surgery Division, Surgery Department, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil
| | - Lydia Masako Ferreira
- Plastic Surgery Division, Surgery Department, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil
| | - Miguel Sabino Neto
- Plastic Surgery Division, Surgery Department, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil
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