title: Transcutaneous electrical nerve stimulation in viability of a random skin flap in nicotine-treated rats.
abstract: BACKGROUND
  Skin flaps are extensively used in plastic surgery, the main postoperative problems being ischemia and necrosis. Nicotine has acute vasoconstrictive properties, diminishing blood flow and increasing the risk of flap necrosis. Transcutaneous electrical nerve stimulation (TENS) was effective in reducing necrosis in random skin flaps in rats. Therefore, the authors decided to test the efficacy of TENS to reduce necrosis in the presence of nicotine.
  
  
  METHODS
  Sixteen adult male Wistar-Escola Paulista de Medicina (EPM) rats were distributed, at random, in 2 groups of 8 animals. The nicotine group (NG) received this drug subcutaneously (1.2 mg/kg/d), for 1 week before flap elevation. The nicotine plus TENS group (NTG) followed the same routine. Immediately after the operative procedure and on the next 2 postoperative days, the treatment group (NTG) was submitted to TENS during an hour under anesthesia. NG animals were sham exposed. After 7 days, the percentages of necrosis were determined.
  
  
  RESULTS
  The NG had a mean value of 45% and the NTG, 21% of necrosis, a difference statistically significant (P < 0.001).
  
  
  CONCLUSIONS
  TENS was effective in the reduction of necrosis in this flap model.
authors.affiliation: Department of Ophthalmology, Federal University of São Paulo, Sao Paulo, Brazil.
authors.forename: Claudia Regina Abrantes
authors.initials: CR
authors.lastname: Russo
authors.forename: Mauro Teixeira
authors.initials: MT
authors.lastname: Leite
authors.forename: Heitor Carvalho
authors.initials: HC
authors.lastname: Gomes
authors.forename: Lydia Masako
authors.initials: LM
authors.lastname: Ferreira
mesh_terms: D000818:Animals; D008297:Male; D009336:Necrosis / Q000517:prevention & control*; D009538:Nicotine / Q000494:pharmacology*; D018722:Nicotinic Agonists / Q000494:pharmacology*; D051381:Rats; D017208:Rats, Wistar; D013524:Surgical Flaps / Q000098:blood supply / Q000473:pathology* / Q000502:physiology; D014022:Tissue Survival / Q000187:drug effects; D004561:Transcutaneous Electric Nerve Stimulation
chemical_list: D018722:Nicotinic Agonists; D009538:Nicotine