Better Survival of Random Pattern Skin Flaps Through the Use of Epigallocatechin Gallate

BACKGROUND Surgical skin flaps are useful, but flap necrosis is a common problem. Epigallocatechin gallate (EGCG), the major polyphenol of green tea, has been investigated as a neovascularization agent to counteract necrosis. OBJECTIVES To evaluate the effect of EGCG on random pattern skin flap survival. MATERIALS AND METHODS The rat dorsal skin flap model was employed. One hundred rats were divided into five groups of equal size. Experimental Group A received local injection of EGCG to the flap, experimental Group B received topical application of EGCG, control Group C received local injection of saline, control Group D received topical application of an acetoneolive oil mixture, and control Group E received no treatment. The surviving area of the flap, regional blood perfusion, capillary density, and vascular endothelial growth factor (VEGF) expression were evaluated. RESULTS We observed a larger area of skin flap survival in Groups A and B than in the control groups. Doppler measurement showed greater perfusion in Groups A and B, and the capillary density and VEGF expression were significantly higher in the experimental animals. CONCLUSION The EGCG treatment enhanced neovascularization and regional perfusion and, as a result, improved skin flap survival.