Research Article| Volume 40, ISSUE 3, P295-299, May 1987

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Dose and time effects of nicotine treatment on the capillary blood flow and viability of random pattern skin flaps in the rat

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      The deleterious effects of nicotine treatment on skin haemodynamics and survival of 4 × 10 cm acute random pattern skin flaps constructed on the dorsum of the rat were studied. Rats were injected subcutaneously with 0.2 ml of saline containing varying doses (0, 1, 2, 4 or 8 mg kg−1; bid) of nicotine for 5 weeks, starting 4 weeks before flap surgery. It was observed that nicotine treatment at the dose of 2 mg kg−1 (bid), or higher, significantly (p < 0.05) decreased the length and area of skin flap survival compared with the control. This dose of nicotine treatment also significantly (p < 0.05) decreased the capillary blood flow and distal perfusion in the skin flaps compared with the control. However, the detrimental effect of nicotine treatment on the survival of acute random pattern skin flaps was not seen if the treatment was started 2 instead of 4 weeks preoperatively. It is concluded that nicotine may cause hypoperfusion and necrosis in acute random pattern skin flap surgery, and the deleterious effects are time-dependent.


        • Armitage A.K.
        Effects of nicotine and tobacco smoke on blood pressure and release of catecholamines from the adrenal glands.
        British Journal of Pharmacology. 1965; 25: 515
        • Craig S.
        • Rees T.D.
        The effects of smoking on experimental skin flaps in hamsters.
        Plastic and Reconstructive Surgery. 1985; 75: 842
        • Cryer P.E.
        • Haymond M.W.
        • Santiago J.V.
        • Shah S.D.
        Norepinephrine and epinephrine release and adrenergic mediation of smoking-associated hemodynamic and metabolic events.
        New England Journal of Medicine. 1976; 295: 573
        • Duncan D.B.
        Multiple range and multiple F tests.
        Biometrics. 1955; 1: 42
        • Falcone R.E.
        • Ruberg R.L.
        Pharmacologic manipulation of skin flaps: Lack of effect of barbiturates or nicotine.
        Plastic and Reconstructive Surgery. 1980; 66: 102
        • Hill P.
        • Wynder E.L.
        Smoking and cardiovascular disease: Effect of nicotine on the serum epinephrine and corticoids.
        American Heart Journal. 1974; 87: 491
        • Hladovec J.
        Endothelial injury by nicotine and its prevention.
        Experientia. 1978; 34: 1585
        • Hugod C.
        Effect of exposure to 0.5 ppm hydrogen cyanide singly or combined with 200 ppm carbon monoxide and/or 5 ppm nitric oxide on coronary arteries, aorta, pulmonary artery and lungs in the rabbit.
        International Archives Occupational Environment and Health. 1979; 44: 13
        • Kaijser L.
        • Wennmalm A.
        Nicotinic acid stimulates prostaglandin synthesis in the rabbit heart without releasing noradrenaline.
        Acta Physiologica Scandinavica. 1978; 102: 246
        • Kaufman T.
        • Eichenlaub E.H.
        • Levin M.
        • Hurwitz D.J.
        • Klain M.
        Tobacco smoking: Impairment of experimental flap survival.
        Annals of Plastic Surgery. 1984; 13: 468
        • Lawrence W.T.
        • Murphy R.C.
        • Robson M.C.
        • Heggers J.P.
        The detrimental effect of cigarette smoking on flap survival: An experimental study in the rat.
        British Journal of Plastic Surgery. 1984; 37: 216
        • Mosely L.H.
        • Finseth F.
        Cigarette smoking: Impairment of digital blood flow and wound healing in the hand.
        The Hand. 1977; 9: 97
        • Neligan P.
        • Pang C.Y.
        • Nakatsuka T.
        • Lindsay W.K.
        • Thomson H.G.
        Pharmacologic action of isoxsuprine in cutaneous and myocutaneous flaps.
        Plastic and Reconstructive Surgery. 1985; 75: 363
        • Nolan J.
        • Jenkins R.A.
        • Kurihara K.
        • Schultz R.C.
        The acute effects of cigarette smoke exposure on experimental skin flaps.
        Plastic and Reconstructive Surgery. 1985; 75: 544
        • Pang C.Y.
        • Neligan P.
        • Nakatsuka T.
        Assessment of microsphere technique for measurement of capillary blood flow in random skin flaps in pigs.
        Plastic and Reconstructive Surgery. 1984; 74: 513
        • Rees T.D.
        • Liverett D.M.
        • Guy C.L.
        The effect of cigarette smoking on skin-flap survival in the face lift patient.
        Plastic and Reconstructive Surgery. 1984; 73: 911
        • Reus W.F.
        • Robson M.C.
        • Zachary L.
        • Heggers J.P.
        Acute effects of tobacco smoking on blood flow in the cutaneous microcirculation.
        British Journal of Plastic Surgery. 1984; 37: 213
        • Sarin C.L.
        • Austin J.C.
        • Nickel W.O.
        Effects of smoking on digital blood-flow velocity.
        Journal of the American Medical Association. 1974; 229: 1327
        • Sasaki G.H.
        • Pang C.Y.
        Hemodynamics and viability of acute neurovascular island skin flaps in rats.
        Plastic and Reconstructive Surgery. 1980; 65: 152
        • Sonnenfeld T.
        • Wennmalm A.
        Inhibition by nicotine of the formation of prostacyclin-like activity in rabbit and human vascular tissue.
        British Journal of Pharmacology. 1980; 71: 609
        • Stewart J.E.
        • Booker W.M.
        • West W.L.
        Chronic nicotine administration and norepinephrine synthesis in the isolated guinea pig heart.
        Archive International Pharmacodynamics. 1973; 201: 362
        • Wennmalm A.
        Interaction of nicotine and prostaglandins in the cardiovascular system.
        Prostaglandins. 1982; 23: 139