The effect of irisin on McFarlane flap survival in diabetic rat animal model

The Effect of Irisin on McFarlane Flap Survival in Diabetic Rat Animal Model Introduction and Objectives: Flaps are commonly used in the reconstruction of tissue defects. Failed flaps are observed in diabetic patients due to impaired wound healing and ischemic damage. Irisin is an adipokine hormone with anti-ischemic, angiogenic, anti-diabetic, and anti-inflammatory effects. Protective effects of Irisin on ischemia and ischemia-reperfusion injury have been observed in rat skin flaps. The aim of this study is to investigate the effect of Irisin on flap perfusion in skin flaps in diabetic rats induced by streptozotocin. Materials and Methods: 24 Wistar-Albino male rats weighing between 250-300 grams were divided into four groups. Streptozotocin was intraperitoneally administered to rats in groups 3 and 4. McFarlane skin flap was performed in all rats in the eighth week. Rats in groups 2 and 4 were given intraperitoneal Irisin for three days. Flap perfusion was measured on the seventh day using SPY immunofluorescent angiography. Rat photos were taken to calculate necrosis rates and histopathological samples were taken to evaluate inflammation, fibrosis, and vascular endothelial growth factor (VEGF) expression. Results: The necrosis percentages of the groups were measured as control 9.9±3.1, Irisin 2.2±2.9, diabetic control 33.7±15.8, and diabetic Irisin 6.2±3.6. In the Irisin group, a numerical decrease in flap necrosis rate and better perfusion were detected compared to the control group (p>0.005). In the diabetic control group, significant differences were observed in flap perfusion and necrosis rates compared to the control, Irisin, and diabetic Irisin groups (p<0.05). In the Irisin group compared to the control group, in the diabetic Irisin group compared to diabetic control group, an increase in VEGF expression, and a decrease in inflammation and fibrosis were observed. Conclusion: Irisin has positive effects on skin flap perfusion in both diabetic and non-diabetic rats. In diabetic rats, Irisin increases flap perfusion and reduces flap necrosis (p<0.05). Irisin increases VEGF expression, flap vascularity, and provides improvement in inflammation and fibrosis.