Effect of ethanolic propolis extract on hypoxia-induced skin flap survival in white rats (Rattus norvegicus) – an experimental study

Sujek M. E. Putra; Amru

doi:10.18203/2349-2902.isj20263337

Authors

Sujek M. E. Putra Department General Surgery, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
Amru Department of Plastic, Reconstructive, and Aesthetics Surgery, Dr. Moewardi General Hospital, Surakarta, Indonesia

DOI:

https://doi.org/10.18203/2349-2902.isj20263337

Keywords:

Propolis, Malondialdehyde, Vascular endothelial growth factor, Necrosis, Acute inflammation

Abstract

Background: Hypoxia in skin flaps promotes oxidative stress and inflammation, which may impair angiogenesis and tissue survival. Propolis contains flavonoids and polyphenols with antioxidant, anti-inflammatory, and angiogenic properties. This study evaluated the effect of ethanolic propolis extract on malondialdehyde (MDA), vascular endothelial growth factor (VEGF), necrosis, and acute inflammation in a rat skin-flap model.

Methods: This experimental pre-test and post-test control-group study included 24 male white rats (Rattus norvegicus) allocated to four groups: control (K) and three treatment groups receiving ethanolic propolis extract 800 mg/kg body weight/day with different flap proportions (P1, P2, and P3). Blood MDA and VEGF levels were measured before and after treatment, and skin-flap specimens were assessed histopathologically. MDA and VEGF were analyzed using one-way ANOVA with post hoc testing, while necrosis and acute inflammation were analyzed using the Kruskal-Wallis test.

Results: MDA decreased least in K (-3.89±0.47) and most in P3 (-6.81±0.53), with a significant between-group difference (p<0.001). VEGF increased least in K (6.30±1.10) and most in P3 (11.55±1.19), also with a significant between-group difference (p<0.001). Between-group differences were not significant for necrosis (p=0.256) or acute inflammation (p=0.513).

Conclusions: Propolis administration significantly increased skin flap survival, as indicated by a decrease in MDA and an increase in VEGF levels. At the histopathological level, propolis administration reduced the degree of necrosis and acute inflammation in the skin flap, although this reduction was not statistically significant.

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