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.