ArticleJPRAS open2026
Effects of extremely low-frequency sinusoidal electromagnetic field therapy on survival and vascularization in a rat 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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Abstract
Aim: This study aimed to evaluate the dose-dependent effects of extremely low-frequency sinusoidal electromagnetic fields (ELF-EMF) on survival and vascularization of random-pattern dorsal skin flaps in rats and to investigate associated histological and molecular changes. Materials and methods: Twenty-one male Sprague-Dawley rats underwent McFarlane dorsal random-pattern flap surgery and were randomly assigned to three groups (n = 7/group): control, low-dose ELF-EMF (0.2 mT), and high-dose ELF-EMF (5 mT). Sinusoidal ELF-EMF exposure (50 Hz) was administered twice daily for 15 min for 14 postoperative days. Flap viability was assessed by digital planimetry. Histological evaluation included hematoxylin-eosin and Masson's trichrome staining. TNF-α immunohistochemistry and quantitative real-time PCR analysis of apoptosis-, inflammation-, and angiogenesis-related genes were performed. Results: The low-dose ELF-EMF group demonstrated significantly higher flap viability than both the control and high-dose groups (76.3 ± 6.9% vs. 55.2 ± 9.1% and 55.7 ± 11.3%, respectively; p < 0.05). Histological analyses showed enhanced re-epithelialization, increased vascularization, improved collagen organization, and reduced inflammatory cell infiltration in the low-dose group. High-dose ELF-EMF did not improve flap survival and was associated with suppression of VEGF and MAPK pathway-related gene expression. The discordance between increased TNF-α mRNA expression and reduced immunohistochemical staining in the low-dose group suggests temporally dynamic and post-transcriptional regulation. Conclusion: Low-dose sinusoidal ELF-EMF improved survival and histological markers of repair in a rat random-pattern skin flap model, whereas high-dose exposure did not confer benefit. These findings support the existence of a dose-dependent biological window for ELF-EMF therapy. Given the exploratory preclinical nature of the study, further mechanistic and translational investigations are required before clinical application.
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