Grants Funded
ASPS/PSF leadership is committed to continuing to provide high levels of investigator-initiated research support to ensure that plastic surgeons have the needed research resources to be pioneers and innovators in advancing the practice of medicine.
Research Abstracts
Search The PSF database to have easy access to full-text grant abstracts from past PSF-funded research projects 2003 to present. All abstracts are the work of the Principal Investigators and were retrieved from their PSF grant applications. Several different filters may be applied to locate abstracts specific to a particular focus area or PSF funding mechanism.
Efficacy of Hydrogen Sulfide Donors in Promoting Flap Survival in a Rodent Model
Principal Investigator
Neekita Jikaria MD
Neekita Jikaria MD
Year
2025
2025
Institution
The Pennsylvania State University College of Medicine
The Pennsylvania State University College of Medicine
Funding Mechanism
Pilot Research Grant
Pilot Research Grant
Focus Area
General Reconstructive, Other
General Reconstructive, Other
Abstract
Project Summary
Flaps are the cornerstone of reconstructive surgery. However, they are subject to malperfusion and necrosis, especially in random pattern skin flaps. This adversely affects patient outcomes. Pharmacological approaches have been utilized clinically to improve flap perfusion, including nitric oxide (NO) modulating agents. NO contributes to blood flow regulation through cGMP-dependent vasodilation. Commonly used NO donors to promote flap perfusion and survival are nitroglycerine (NTG)-based products. However, they are plagued by variable efficacy and unwanted side effects, such as headaches, thus preventing sustained usage. Therefore, newer modalities and delivery options are warranted. Hydrogen sulfide (H2S) is a gaseous transmitter with significant vasoactive properties that also plays a major role in blood flow regulation. Produced by cystathionine-y-lyase and 3-mercaptopyruvate
sulphurtransferase, it induces vasodilation through potassium-dependent ATP channels and membrane hyperpolarization. At longer intervals, H2S can promote angiogenesis. Thus, either it or its sodium salt, disodium sulfide (Na2S), may present an easily translatable option to maximize initial flap perfusion while concurrently stimulating angiogenesis. We hypothesize that Na2S/H2S injection into the flap immediately following elevation will promote survival by acutely increasing blood flow and maximizing ensuing angiogenesis, with both processes being augmented via sustained-release micelles. To test our hypothesis, we propose two specific aims 1) To
show that Na2S/H2S is more effective than NTG in flap perfusion and survival, and its effects can be synergized when delivered by sustained-release polymeric micelles. 2) To show that H2S is more effective than NTG in promoting flap angiogenesis and survival and that its effects can be synergized when delivered by sustained-release polymeric micelles. Flaps will be created, followed by
injection of the pharmacologic agents. Flap perfusion and angiogenesis will be evaluated by thermography, laser-perfusion imaging, microdialysis, immunohistochemistry, protein analysis, and whole-mount angiography. The expected outcome is a controllable drug delivery system that can improve flap survival by both augmenting initial perfusion and subsequent angiogenesis and creating techniques at the engineering-surgery interface. These results will positively impact the reliability of random-pattern skin flaps and the reconstructive outcomes of patients.
Impact Statement
The proposed research will foster advances in reconstructive and regenerative surgery. The expected outcome is a controllable novel drug delivery system that can be used to improve flap survival by both augmenting initial perfusion and subsequent angiogenesis while also creating experimental techniques at the engineering-surgery interface. These results will have a positive impact by improving the reliability of random pattern skin flaps and the reconstructive outcomes of our patients.
Project Summary
Flaps are the cornerstone of reconstructive surgery. However, they are subject to malperfusion and necrosis, especially in random pattern skin flaps. This adversely affects patient outcomes. Pharmacological approaches have been utilized clinically to improve flap perfusion, including nitric oxide (NO) modulating agents. NO contributes to blood flow regulation through cGMP-dependent vasodilation. Commonly used NO donors to promote flap perfusion and survival are nitroglycerine (NTG)-based products. However, they are plagued by variable efficacy and unwanted side effects, such as headaches, thus preventing sustained usage. Therefore, newer modalities and delivery options are warranted. Hydrogen sulfide (H2S) is a gaseous transmitter with significant vasoactive properties that also plays a major role in blood flow regulation. Produced by cystathionine-y-lyase and 3-mercaptopyruvate
sulphurtransferase, it induces vasodilation through potassium-dependent ATP channels and membrane hyperpolarization. At longer intervals, H2S can promote angiogenesis. Thus, either it or its sodium salt, disodium sulfide (Na2S), may present an easily translatable option to maximize initial flap perfusion while concurrently stimulating angiogenesis. We hypothesize that Na2S/H2S injection into the flap immediately following elevation will promote survival by acutely increasing blood flow and maximizing ensuing angiogenesis, with both processes being augmented via sustained-release micelles. To test our hypothesis, we propose two specific aims 1) To
show that Na2S/H2S is more effective than NTG in flap perfusion and survival, and its effects can be synergized when delivered by sustained-release polymeric micelles. 2) To show that H2S is more effective than NTG in promoting flap angiogenesis and survival and that its effects can be synergized when delivered by sustained-release polymeric micelles. Flaps will be created, followed by
injection of the pharmacologic agents. Flap perfusion and angiogenesis will be evaluated by thermography, laser-perfusion imaging, microdialysis, immunohistochemistry, protein analysis, and whole-mount angiography. The expected outcome is a controllable drug delivery system that can improve flap survival by both augmenting initial perfusion and subsequent angiogenesis and creating techniques at the engineering-surgery interface. These results will positively impact the reliability of random-pattern skin flaps and the reconstructive outcomes of patients.
Impact Statement
The proposed research will foster advances in reconstructive and regenerative surgery. The expected outcome is a controllable novel drug delivery system that can be used to improve flap survival by both augmenting initial perfusion and subsequent angiogenesis while also creating experimental techniques at the engineering-surgery interface. These results will have a positive impact by improving the reliability of random pattern skin flaps and the reconstructive outcomes of our patients.
Biography
Neekita Jikaria is a resident physician in the general surgery program at Penn State Milton S. Hershey Medical Center. She was born in India and immigrated to the United States at 11. She earned a bachelor’s degree in integrative neuroscience from the State
University of New York in Binghamton University. Her passion for translational research began during her time as a postbaccalaureate research fellow at the National Institute of Health, where she studied both pre-clinical and clinical manifestations of traumatic brain injury. She went on to earn a Doctorate of Medicine from the Pennsylvania State University College of Medicine, where she is currently completing her training in general surgery. Currently, she is taking two career development years to pursue basic and translational science research under the guidance of Dr. Dino Ravnic. Her current research interests are microvascular angiogenesis, tissue engineering, and regeneration. She hopes to pursue a career in academic plastic surgery, integrating innovation
and technical skills to make a meaningful impact in the field of reconstructive surgery.
Neekita Jikaria is a resident physician in the general surgery program at Penn State Milton S. Hershey Medical Center. She was born in India and immigrated to the United States at 11. She earned a bachelor’s degree in integrative neuroscience from the State
University of New York in Binghamton University. Her passion for translational research began during her time as a postbaccalaureate research fellow at the National Institute of Health, where she studied both pre-clinical and clinical manifestations of traumatic brain injury. She went on to earn a Doctorate of Medicine from the Pennsylvania State University College of Medicine, where she is currently completing her training in general surgery. Currently, she is taking two career development years to pursue basic and translational science research under the guidance of Dr. Dino Ravnic. Her current research interests are microvascular angiogenesis, tissue engineering, and regeneration. She hopes to pursue a career in academic plastic surgery, integrating innovation
and technical skills to make a meaningful impact in the field of reconstructive surgery.