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Effect of botulinum toxin A on vasoconstriction and sympathetic neurotransmitters in a murine random pattern skin flap model
Author(s) -
Roh Tai Suk,
Jung Bok Ki,
Yun Insik,
Lew Dae Hyun,
Kim Young Seok
Publication year - 2017
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/wrr.12501
Subject(s) - nitric oxide synthase , nitric oxide , saline , medicine , cd31 , vasoconstriction , neuropeptide y receptor , anesthesia , botulinum toxin , vasomotor , neuropeptide , calcitonin gene related peptide , nerve growth factor , norepinephrine , western blot , immunohistochemistry , surgery , chemistry , dopamine , receptor , biochemistry , gene
Blood supply is the most important factor determining the survival of a skin flap. Botulinum toxin‐A (Botox‐A) is used as pharmacologic agent not only for aesthetic purposes, but also for its vasomotor actions. This study was conducted to establish whether local application of Botox‐A increased survival of random pattern skin flaps in rats by changing the expression of neurotransmitters. Forty adult Sprague–Dawley rats with a caudally‐based random pattern skin flap were divided into two groups: Botox‐A group and saline group. Surviving flap area and cutaneous blood flow in the flap were evaluated on postoperative days 3 and 7. After injection of Botox‐A, changes in vessels were analyzed using immunohistochemical staining. Levels of norepinephrine, neuropeptide‐Y, nitric oxide, and endothelial nitric oxide synthase were analyzed quantitatively by high performance liquid chromatography, Western blot, and colorimetric assay. The survived area in the Botox‐A group was significantly higher than that in the control group on postoperative days 3 and 7. Blood flow in the Botox‐A group was significantly high in the proximal and middle areas immediately after the operation. The number of CD31‐positive vessels in the Botox‐A group was significant greater than that in the control group. Norepinephrine level in the Botox‐A group decreased significantly immediately after flap elevation and at postoperative day 3. There were no significant differences in neuropeptide‐Y level between the two groups. Nitric oxide level did not change significantly in either group despite the increase in endothelial nitric oxide synthase immediately after flap elevation and at 3 days postoperatively. In conclusion, Botox‐A increased vascular blood flow and viable flap area in rats by reducing norepinephrine level. In contrast, neuropeptide‐Y, another vasoconstrictor, was not affected by Botox‐A. Nitric oxide, a vasodilator, was also not affected by Botox‐A, despite the significant increase in endothelial nitric oxide synthase expression in the flaps.