Study of Different Therapeutic Agents for the Prevention of Ischemia Reperfusion Injury in Free Skin Flap | ||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||
| Article 16, Volume 43, Issue 1, January 2019, Pages 93-100 PDF (16.63 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejprs.2019.65164 | ||
| Authors | ||
| Khaled El Gazzar* 1; Ibrahim Hussein Kamel1; Eman Nagy1; Eman Abdel Salam Ibrahim2; Mai Mosad Morsy3; Ahmed Ali3 | ||
| 1The Departments of Plastic Surgery, Faculty of Medicine, Ain Shams University | ||
| 2The Departments of Pathology, Faculty of Medicine, Ain Shams University | ||
| 3The Departments of Plastic Surgery , Faculty of Medicine, Ain Shams University | ||
| Abstract | ||
| Background: In clinical practice a certain fraction of skin flap transfers fail invariably because of ischemia-reperfusion injury. This study was designed to develop experimental model of ischemia-reperfusion injury in rat skin flap to investigate the effect of certain pharmacological agents on prevention or reducing ischemia-reperfusion injury. Methods: A “4x6” cm hemi epigastric skin flap of adult albino rat was raised and subjected to 8 hours of ischemia then reperfusion for 48 hours. A total of 40 flaps were studied and divided randomly into 5 groups. 15 minutes prior to reperfusion, all flaps (except group I) were infused by saline, Vitamin C, Heparin, and Monoclonal antibody LY-6G to groups II, III, IV and V respectively. After 2 days, macroscopic evaluation of flap survival, histological study of neutrophil infiltration, and biochemical tissue enzymes assay were performed. Results: All flaps survived completely in sham group I with minimal neutrophilia while the mean percentage of flap < br />necrosis in control group II was 90.5% with massive neutrophilia. The mean percentage of flap survival were 71, 80, and 84 percent in groups III, IV, and V respectively. Neutrophil count of flap tissue showed significant reduction as compared with control flaps. Tissue enzymes assay showed stable level of superoxide dismutase activity in flaps pretreated by drugs compared to control group. Caspase-3 enzyme activity showed variable decrements in flaps pretreated with the different drugs when compared with control flaps. Conclusion: The use of certain pharmacological agents could significantly reduce the effect of ischemia-reperfusion injury on skin flaps. | ||
| Keywords | ||
| Ischemia-reperfusion – Vitamin C – Heparin –; Monoclonal antibody | ||
| References | ||
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