{
  "abstract": "Objectives: Random-pattern skin flaps remain vulnerable to distal ischemia and partial necrosis despite surgical refinements. Hydrogen sulfide (H₂S) is an endogenous gasotransmitter with cytoprotective and proangiogenic properties. This study evaluated the effects of sodium hydrogen sulfide (NaHS) on flap viability, microvascular perfusion, and histological outcomes in a rat dorsal random-pattern skin flap model.\n\nMethods: Twenty-one male Sprague–Dawley rats were randomized into control, sham, and NaHS groups (n = 7 each). NaHS (200 µg/kg/day) was administered intraperitoneally for 15 days prior to flap elevation. A 9 × 3 cm caudally based dorsal flap was created using the McFarlane model. On postoperative day 7, perfusion was objectively assessed using indocyanine green fluorescence angiography. Inflammation, re-epithelialization, vascularization, and collagen organization were assessed using semi-quantitative scoring, whereas the apoptotic index was determined quantitatively based on TUNEL-positive cell counts.\n\nResults: NaHS significantly increased viable flap area and reduced distal necrosis compared with control and sham groups. Fluorescence imaging demonstrated enhanced distal perfusion and a denser microvascular network in the NaHS group. Histologically, NaHS promoted complete re-epithelialization, organized collagen structure, and markedly increased vascularization (p < 0.01), while significantly decreasing inflammation and apoptosis (p < 0.001).\n\nConclusions: Sodium hydrogen sulfide improved random-pattern skin flap viability by enhancing microvascular perfusion and attenuating ischemia-induced inflammation and apoptosis. These findings suggest that H₂S donors may represent a potential pharmacologic approach to improve ischemic flap survival in reconstructive surgery.",
  "abstract_shown": true,
  "affiliations": [
    "Istanbul Medeniyet University, Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Turkey",
    "Istanbul Aydın University, Department of Histology and Embryology, Faculty of Medicine, Turkey",
    "Experimental Animal Application and Research Center, Maltepe University, Turkey"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Mustafa Onal"
    },
    {
      "affs": [
        1
      ],
      "name": "Aysun Ozbay Onal"
    },
    {
      "affs": [
        0
      ],
      "name": "Mehmet Goktug Esmer"
    },
    {
      "affs": [
        2
      ],
      "name": "Oguz Kaan Tombul"
    },
    {
      "affs": [
        0
      ],
      "name": "Merdan Serin"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1gxtrr5etkqm6.bib",
  "cited_by": 0,
  "doi": "10.1016/j.jpra.2026.10.005",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13721927/?tool=EBI",
  "id": "1gxtrr5etkqm6",
  "issns": [
    "2352-5878"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13721927",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2746|Reconstructive Surgery and Microvascular Techniques"
    ]
  ],
  "openalex": "W7223215814",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13721927/pdf/?tool=EBI",
  "pmcid": "PMC13721927",
  "pmid": "42965142",
  "published": "2026-10-22",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/1gxtrr5etkqm6.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:37Z",
      "native_id": "PMC:PMC13721927",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13721927"
    },
    {
      "first_seen": "2026-11-03T12:22:32Z",
      "native_id": "PMC13721927",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.jpra.2026.10.005"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Reconstructive Surgery and Microvascular Techniques",
      "subfield": "surgery"
    }
  ],
  "title": "Sodium hydrogen sulfide enhances microcirculation and survival in random-pattern skin flaps: An experimental rat study",
  "title_text": "Sodium hydrogen sulfide enhances microcirculation and survival in random-pattern skin flaps: An experimental rat study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:22:32Z",
  "url": "https://research.draconitic.com/paper/1gxtrr5etkqm6",
  "venue": "JPRAS open",
  "versions": []
}