Combination therapy profoundly improved skin flap survival by modulating KATP channels and nitric oxide

The study conducted on Sprague-Dawley rats (48 rats divided into 8 groups of 6 each) demonstrated that a combination therapy of azelaic acid, minoxidil, and caffeine significantly improved skin flap survival following surgery. This improvement was evidenced by a decrease in necrosis, lower tissue malondialdehyde (MDA) levels, reduced expression of the pro-apoptotic protein Bax, and increased tissue nitric oxide content and inducible nitric oxide synthase (iNOS) expression. The beneficial effects of the therapy were negated when either L-NAME, an iNOS inhibitor, or glibenclamide, a KATP channel blocker, was administered beforehand. The study concluded that the combination therapy effectively rescued skin flaps from necrosis by modulating KATP channels and the nitric oxide pathway, which could have potential clinical applications for improving the survival of skin flaps.