title: Effect of nicotine treatment and withdrawal on random-pattern skin flaps in rats.
abstract: BACKGROUND
  Tobacco use is associated with a high incidence of skin necrosis after surgery. The ideal timing for the cessation of tobacco use before plastic surgery has not, however, been precisely determined. The aim of this work was to define the ideal duration of nicotine withdrawal prior to random-pattern skin flap surgery in rats.
  
  
  METHODS
  Groups of 11 animals were subcutaneously injected with saline or nicotine (2mg/kg) twice a day and subjected to random-pattern skin flap surgery according to the following protocol: Group I: continuously injected with saline 4 weeks before and 1 week after the surgery; Group II: injected with nicotine for 4 weeks until the day of the surgery; Group III: injected with nicotine for 4 weeks until one day before the surgery; Group IV: injected with nicotine for 4 weeks until 5 days before the surgery; Group V: injected with nicotine for 4 weeks until 10 days before the surgery; Group VI: continuously injected with nicotine for 4 weeks before and 1 week after the surgery. McFARLANE skin flaps were performed on the dorsal skin, and the rats were sacrificed 1 week after the surgery.
  
  
  RESULTS
  The necrotic area was smaller in group I (8.85cm2) than in group II (12.15cm2), III (12.88cm2) and VI (14.84cm2) (ANOVA p<0.0001). There was no difference between groups I, IV (10.13cm2) and V (9.27cm2).
  
  
  CONCLUSIONS
  In conclusion, 5 days before surgery was considered the ideal time for nicotine withdrawal in this experimental model.
authors.affiliation: Escola Bahiana de Medicina e Saúde Pública, Av. Dom João VI no. 274, Brotas, 40290-000 Salvador, BA, Brazil. cirurgiaplastica@humbertocampos.med.br
authors.forename: José Humberto O
authors.initials: JH
authors.lastname: Campos
authors.forename: Heitor Carvalho
authors.initials: HC
authors.lastname: Gomes
authors.forename: Washington L C
authors.initials: WL
authors.lastname: dos-Santos
authors.forename: Mauricio
authors.initials: M
authors.lastname: Cardeal
authors.forename: Lydia Masako
authors.initials: LM
authors.lastname: Ferreira
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D004334:Drug Administration Schedule; D007279:Injections, Subcutaneous; D009336:Necrosis; D009538:Nicotine / Q000008:administration & dosage / Q000633:toxicity*; D018722:Nicotinic Agonists / Q000008:administration & dosage / Q000633:toxicity*; D051381:Rats; D012867:Skin / Q000187:drug effects* / Q000473:pathology; D013524:Surgical Flaps / Q000473:pathology; D014022:Tissue Survival / Q000187:drug effects*; D028761:Withholding Treatment
chemical_list: D018722:Nicotinic Agonists; D009538:Nicotine