The Vasodilator Effect of a Cream Containing 10% Menthol and 15% Methyl Salicylate on Random-Pattern Skin Flaps in Rats

 

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Background It is still difficult to prevent partial or full-thickness flap necrosis. In this study, the effects of a cream containing menthol and methyl salicylate on the viability of randompattern skin flaps were studied.

Methods Forty female Sprague-Dawley rats were divided into two equal groups. Caudally based dorsal random-pattern skin flaps were elevated, including the panniculus carnosus. In the study group, 1.5 mL of a cream containing menthol and methyl salicylate was applied to the skin of the flap, and saline solution (0.9%) was used in the control group. Upon completion of the experiment, flap necrosis was analyzed with imaging software and radionuclide scintigraphy. Histopathological measurements were made of the percentage of viable flaps, the number of vessels, and the width of the panniculus carnosus muscle.

Results According to the photographic analysis, the mean viable flap surface area in the study group was larger than that in the control group (P=0.004). According to the scintigrams, no change in radioactivity uptake was seen in the study group (P>0.05). However, a significant decrease was observed in the control group (P=0.006). No statistically significant differences were observed between the groups in terms of the percentage of viable flaps, the number of vessels, or the width of the panniculus carnosus muscle (P>0.05).

Conclusions Based on these results, it is certain that the cream did not reduce the viability of the flaps. Due to its vasodilatory effect, it can be used as a component of the dressing in reconstructive operations where skin perfusion is compromised.

Publication History

Received: 10 February 2015

Accepted: 17 August 2015

Article published online:
05 May 2022

© 2015. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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• References

• 1 Rinker B, Fink BF, Barry NG. et al. The effect of calcium channel blockers on smoking-induced skin flap necrosis. Plast Reconstr Surg 2010; 125: 866-871
  CrossrefPubMedGoogle Scholar
• 2 Chen W, Yang D, Wang P. et al. Microencapsulated myoblasts transduced by the vascular endothelial growth factor (VEGF) gene for the ischemic skin flap. Aesthetic Plast Surg 2011; 35: 326-332
  CrossrefPubMedGoogle Scholar
• 3 Miyawaki T, Jackson IT, Bier UC. et al. The effect of capsaicin ointment on skin for the survival of a cutaneous flap. Eur J Plast Surg 2001; 24: 28-30
  CrossrefGoogle Scholar
• 4 Pal S, Khazanchi RK, Moudgil K. An experimental study on the effect of nifedipine on ischaemic skin flap survival in rats. Br J Plast Surg 1991; 44: 299-301
  CrossrefPubMedGoogle Scholar
• 5 Stadelmann WK, Hess DB, Robson MC. et al. Aprotinin in ischemia-reperfusion injury: flap survival and neutrophil response in a rat skin flap model. Microsurgery 1998; 18: 354-361
  CrossrefPubMedGoogle Scholar
• 6 Patel T, Ishiuji Y, Yosipovitch G. Menthol: a refreshing look at this ancient compound. J Am Acad Dermatol 2007; 57: 873-878
  CrossrefPubMedGoogle Scholar
• 7 Kamatou GP, Vermaak I, Viljoen AM. et al. Menthol: a simple monoterpene with remarkable biological properties. Phytochemistry 2013; 96: 15-25
  CrossrefPubMedGoogle Scholar
• 8 Johnson CD, Melanaphy D, Purse A. et al. Transient receptor potential melastatin 8 channel involvement in the regulation of vascular tone. Am J Physiol Heart Circ Physiol 2009; 296: H1868-H1877
  CrossrefPubMedGoogle Scholar
• 9 Namer B, Seifert F, Handwerker HO. et al. TRPA1 and TRPM8 activation in humans: effects of cinnamaldehyde and menthol. Neuroreport 2005; 16: 955-959
  CrossrefPubMedGoogle Scholar
• 10 Olive JL, Hollis B, Mattson E. et al. Vascular conductance is reduced after menthol or cold application. Clin J Sport Med 2010; 20: 372-376
  PubMedGoogle Scholar
• 11 Topp R, Winchester LJ, Schilero J. et al. Effect of topical menthol on ipsilateral and contralateral superficial blood flow following a bout of maximum voluntary muscle contraction. Int J Sports Phys Ther 2011; 6: 83-91
  PubMedGoogle Scholar
• 12 Chotani MA, Flavahan S, Mitra S. et al. Silent alpha(2C)-adrenergic receptors enable cold-induced vasoconstriction in cutaneous arteries. Am J Physiol Heart Circ Physiol 2000; 278: H1075-H1083
  CrossrefPubMedGoogle Scholar
• 13 Green DJ, O'Driscoll G, Blanksby BA. et al. Control of skeletal muscle blood flow during dynamic exercise: contribution of endothelium-derived nitric oxide. Sports Med 1996; 21: 119-146
  CrossrefPubMedGoogle Scholar
• 14 Ohta T, Imagawa T, Ito S. Involvement of transient receptor potential vanilloid subtype 1 in analgesic action of methylsalicylate. Mol Pharmacol 2009; 75: 307-317
  CrossrefPubMedGoogle Scholar
• 15 Davis RE, Wachholz JH, Jassir D. et al. Comparison of topical anti-ischemic agents in the salvage of failing random-pattern skin flaps in rats. Arch Facial Plast Surg 1999; 1: 27-32
  CrossrefPubMedGoogle Scholar
• 16 Hong CZ, Shellock FG. Effects of a topically applied counterirritant (Eucalyptamint) on cutaneous blood flow and on skin and muscle temperatures: a placebo-controlled study. Am J Phys Med Rehabil 1991; 70: 29-33
  CrossrefPubMedGoogle Scholar
• 17 Kunta JR, Goskonda VR, Brotherton HO. et al. Effect of menthol and related terpenes on the percutaneous absorption of propranolol across excised hairless mouse skin. J Pharm Sci 1997; 86: 1369-1373
  CrossrefPubMedGoogle Scholar
• 18 Martin D, Valdez J, Boren J. et al. Dermal absorption of camphor, menthol, and methyl salicylate in humans. J Clin Pharmacol 2004; 44: 1151-1157
  CrossrefPubMedGoogle Scholar
• 19 Hammond DC, Brooksher RD, Mann RJ. et al. The dorsal skin-flap model in the rat: factors influencing survival. Plast Reconstr Surg 1993; 91: 316-321
  CrossrefPubMedGoogle Scholar
• 20 Jones M, Zhang F, Blain B. et al. Influence of recipient-bed isolation on survival rates of skin-flap transfer in rats. J Reconstr Microsurg 2001; 17: 653-658
  Article in Thieme ConnectPubMedGoogle Scholar
• 21 Cheon YW, Tark KC, Kim YW. Better survival of random pattern skin flaps through the use of epigallocatechin gallate. Dermatol Surg 2012; 38: 1835-1842
  CrossrefPubMedGoogle Scholar
• 22 Komorowska-Timek E, Chen SG, Zhang F. et al. Prolonged perivascular use of verapamil or lidocaine decreases skin flap necrosis. Ann Plast Surg 1999; 43: 283-288
  CrossrefPubMedGoogle Scholar
• 23 Cheang WS, Lam MY, Wong WT. et al. Menthol relaxes rat aortae, mesenteric and coronary arteries by inhibiting calcium influx. Eur J Pharmacol 2013; 702: 79-84
  CrossrefPubMedGoogle Scholar
• 24 Topp R, Ledford ER, Jacks DE. Topical menthol, ice, peripheral blood flow, and perceived discomfort. J Athl Train 2013; 48: 220-225
  CrossrefPubMedGoogle Scholar
• 25 Ghavami A, Nutt MP, Hardy SP. Heat shock protein and high-dose aspirin: effects on random skin flap survival in a rat model. Ann Plast Surg 2002; 48: 60-67
  CrossrefPubMedGoogle Scholar