Effects of Combination Therapy with Captopril and Angiotensin II on the Viability of Random-pattern Skin Flaps in Diabetic Rat Model

Abstract

Objective: Diabetes mellitus leads to tissue damage by erythrocyte aggregation and an endothelial dysfunction-mediated disturbance in vascularization. These mechanisms facilitate the formation of skin wounds. As skin flaps are often used in the treatment of diabetic wounds, enhancing the blood supply and lowering blood glucose levels have emerged as important factors to increase the success of treatment using skin flaps. Therefore, in this study, the effectiveness of captopril and angiotensin II treatments were investigated to determine if they increased blood flow to skin flaps to protect their viability in an experimental diabetic rat model. Material and Methods: The experiment was conducted using 45 rats. Nine constituted the sham group, whereas diabetes was induced in 36 of them by an intraperitoneal injection of streptozotocin. Skin flaps (3×8 cm in diameter) were prepared, separated, and consequently reimplanted with staplers to their original place at the dorsum of the rats. Diabetic rats were treated with saline (n=9), angiotensin II (n=9), captopril (n=9), captopril+angiotensin II (n=9) during the postoperative period. Flap viability was assessed by clinical and histopathological findings. Results: The percentage of flap viability in diabetic rats was found to be significantly higher in the captopril+angiotensin II group than in the captopril group and was lowest in the angiotensin II group. Additionally, both individual and combined use of captopril and angiotensin II were found to increase the intensity of blood vessels compared to the administration of saline alone in diabetic rats. Conclusion: Our study showed that the use of captopril and angiotensin II could increase the viability of skin flaps in diabetic rats.

Keywords

• Angiotensin II
• captopril
• diabetes mellitus