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Trans-Cinnamaldehyde Increases Random Pattern Flap Survival Through Activation of the Nitric Oxide Pathway
Xiaobin Luo1, Bin Zhao2, Baoxia Chen2
1Department of Orthopedics (Division of Hand Surgery), The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Key Laboratory of Orthopedics of Zhejiang Province, The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China.
Trans-cinnamaldehyde significantly improves random pattern skin flap survival by promoting angiogenesis via the nitric oxide pathway. A dose of 20 mg/kg is recommended for plastic surgery reconstruction.
Area of Science:
- Plastic Surgery
- Regenerative Medicine
- Pharmacology
Background:
- Random pattern skin flap necrosis limits reconstructive surgery.
- Trans-cinnamaldehyde exhibits antibacterial, anticancer, and antioxidant properties.
- Nitric oxide's role in flap survival is not fully understood.
Purpose of the Study:
- To investigate the efficacy of trans-cinnamaldehyde in enhancing skin flap survival.
- To elucidate the underlying mechanism involving the nitric oxide pathway.
- To determine the optimal dosage of trans-cinnamaldehyde for flap survival.
Main Methods:
- 140 Sprague-Dawley rats were divided into seven groups.
- Trans-cinnamaldehyde (10, 20, 30 mg/kg) administered orally.
- Nitric oxide synthase inhibition assessed using L-NAME.
- Flap survival evaluated on postoperative day 7.
Main Results:
- 20 mg/kg trans-cinnamaldehyde significantly increased flap survival (P < 0.001).
- L-NAME coadministration attenuated the protective effect of trans-cinnamaldehyde.
- Histopathology, laser Doppler, and arteriography showed increased perfusion, angiogenesis, and capillary count.
- Immunohistochemistry revealed elevated CD34, eNOS, and VEGF expression.
Conclusions:
- Trans-cinnamaldehyde enhances skin flap survival through the nitric oxide synthase pathway.
- The compound promotes angiogenesis and collagen deposition.
- A dosage of 20 mg/kg trans-cinnamaldehyde is recommended for clinical application.
