ArticleJPRAS open2026
D-ribose-loaded hydrogel modulates necrosis progression and wound stability in a rabbit random-pattern skin flap model.
Article in JPRAS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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7 authors.
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Abstract
Background: Random-pattern skin flaps remain highly susceptible to ischemic injury, resulting in progressive distal necrosis and wound instability. Early metabolic failure is a central component of ischemia-reperfusion injury in flap tissue. D-ribose, a pentose sugar involved in adenine nucleotide and adenosine triphosphate (ATP) resynthesis, may support metabolic recovery in ischemic environments. This study investigated whether local delivery of a D-ribose-loaded hydrogel modulates necrosis progression and wound stability in a rabbit random-pattern skin flap model. Methods: Twenty-six adult male New Zealand White rabbits were randomly assigned to receive either a D-ribose-loaded chitosan hydrogel or an identical ribose-free control. A standardized caudally based random-pattern dorsal skin flap was elevated in each animal. Flap necrosis percentage, absolute necrotic area, and wound dehiscence were assessed using standardized digital imaging on postoperative days 3, 7, 9, 11, and 14. Flap failure was defined as development of ≥50% necrosis. Longitudinal changes were analyzed using linear mixed-effects modeling, while time-to-event outcomes were evaluated using Kaplan-Meier analysis with Cox regression. Dehiscence outcomes were analyzed using logistic regression and analysis of covariance. Results: D-ribose hydrogel significantly modulated the temporal progression of flap necrosis, with a distinct group × time interaction compared with controls ( Conclusion: Local delivery of a D-ribose-loaded hydrogel modulated necrosis progression and improved wound stability in a rabbit random-pattern skin flap model. These findings support metabolically active hydrogel-based strategies as a promising adjunct to enhance flap reliability under ischemic conditions.
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