Tanshinone IIA Pretreatment Protects Free Flaps Against Hypoxic Injury by Upregulating Stem Cell-Related Biomarkers in Epithelial Skin Cells

The study demonstrated that Tanshinone IIA (TSA) pretreatment protected free flaps against hypoxic injury by enhancing tissue resistance to hypoxia and increasing the area of surviving tissue in an ischemic flap model. This protective effect was attributed to the activation of the Wnt signaling pathway and the upregulation of stem cell-related biomarkers such as β-catenin, SOX2, OCT4, and Nanog in epithelial skin cells. TSA also increased the expression of VEGF and CD34, which are involved in angiogenesis and microvessel density. The study involved BALB/c mice, with 6 mice in the TSA group and 6 in the control group, and suggested that TSA could potentially improve the success of free flap surgery in humans, although further research was needed to explore its clinical applicability.