Increased survival of skin flaps by scavengers of superoxide radical (original) (raw)
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Effect of allopurinol, superoxide-dismutase, and hyperbaric oxygen on flap survival
Microsurgery, 2002
The effect of allopurinol, superoxide-dismutase, and hyperbaric oxygen was compared on axial pattern skin flap survival. An abdominal flap based on the inferior epigastric pedicle was raised in rats for this purpose. Three experimental groups were studied. In the first group, adult male Wistar rats received 50 mg/kg I.P. of allopurinol. The second received 20,000 I.U./kg of superoxide-dismutase. The third group was submitted to hyperbaric oxygen therapy. The flaps were exposed to 8-h warm ischemia. Flap survival was evaluated on postoperative day 7. All flaps survived, and the mean survival areas were 63.53%, 83.03%, and 55.98%, respectively, in the allopurinol, superoxide-dismutase, and hyperbaric groups. The percentage of flap necrosis was significantly smaller in all experimental groups when compared to controls (P < 0.05). It was clear that the superoxide-dismutase group had better results on axial pattern ischemic skin flap survival, under the tested conditions. The tested methods improved flap survival to ischemic injury, and the flap designed is a reliable model for further investigations. © 2002 Wiley-Liss, Inc. MICROSURGERY 22:352–360 2002
Head & Neck, 2013
Background. Studies have focused on enhancing flap viability using superoxide dismutase (SOD), but only a few used SOD from human origin, and most gave the compound systemically. We evaluated the ability of SOD to improve random skin flap survival using human recombinant copper-zinc superoxide dismutase (Hr-CuZnSOD) in variable doses, injected intradermally into the flap. Methods. Seventy male Sprague Dawley rats were randomly assigned into 4 groups. Cephalic random pattern flaps were elevated on their backs and intradermal injections of different dosages of Hr-CuZnSOD were given 15 minutes before surgery. Flap survival was evaluated by fluorescein fluorescence. Analysis of variance (ANOVA) and t test statistical analyses were performed. Results. Flap survival in all treated groups was significantly better than in the controls. Conclusions. The beneficial effect of HR-CuZnSOD on flap survival is attained when it is given intradermally into the flap tissue. Theoretically, Hr-CuZnSOD delivered with local anesthetics used in flap elevation may be a valuable clinical tool. V
British Journal of Plastic Surgery, 1991
In attempts to substantiate the possible participation of reactive oxygen species, and the signilicance of the xanthhre oxidase system in both post-ischaemic reperfusion necrosis of the island flap and distal necrosis of the pedicle flap, and to develop oew pharmacological measures for salvaging ilap necrosis, a series of experiments were made using an island flap model and a random-pattern flap model in rats. The results were as follows: (1) Epoxysuccinyl derivative (E&c), allopurhrol and L-SOD salvaged post-ischaemic reperfusion necrosis of the island flaps; (2) E-64c and allopurhrol did not salvage anticipated necrosis of the distal region of random flaps but L-SOD did; (3) tissue SOD activity did not reflect the fate of the island flap, but did of the distal region of the random flap. These results demonstrated a possible involvement of ROS in both post-ischaemic necrosis of island flaps and distal necrosis of random flaps. However, xanthine oxidase was signitlcant in producing ROS only in the former.
The Effect of Hyaluronidase and Dimethyl Sulfoxide (DMSO) on Experimental Skin Flap Survival
Annals of Plastic Surgery, 1983
Hyaluronidase has been shown clinically and experimentally to reduce the effects of tissue ischemia in myocardial infarction and hemorrhagic shock. Dimethyl sulfoxide (DMSO) has been shown to reverse the effects of cerebral ischemia in the primate model. A caudally based dorsal skin flap in the rat was used to study the effects of these two drugs in physiological doses on skin flaps, and to investigate their mechanisms of action. This study demonstrates that both hyaluronidase and DMSO, which are nontoxic in physiological doses, can increase the surviving length of an experimental skin Pap. It is hypothesized that these substances exert their effect by decreasing tissue edema and by aiding in the transport of nutritive substances to the flap during its acute phase.
Effect of dimethyl sulphoxide on necrosis of skin flaps in rats
Plastic Surgery, 1998
The effect of dimethyl sulphoxide (DMSO) on necrosis of the distal portion of random skin flaps was studied. Twenty-eight Wistar-EPM rats each had a random skin flap created that measured 10x4 cm. A plastic barrier was interposed between the flap and the bed. Rats in group 1 received distilled water and those in group 2 received DMSO 2 mL/kg/day by intragastric lavage for seven days. The percentages of necrotic area were calculated in the two groups, and malondialdehyde (MDA) was measured in the serum, in the samples of normal skin and in the transition region from viable to necrotic skin. Statistical analysis showed that DMSO was efficient in reducing the necrotic areas and MDA values compared with results from group 1. Statistical analysis also revealed that the action of DMSO as an antioxidant can be inferred to be the mechanism responsible for the results obtained.
Annals of Plastic Surgery, 2007
We made an experimental study on rabbit ears using an ischemic flow-through venous flap model to determine the changes in levels of reactive oxygen species (ROS) in venous flaps and effects of exogenous antioxidants on endogenous antioxidant superoxide dismutase (SOD) and ROS indicator malonyldialdehyde (MDA) levels and on flap survival. Mean SOD level significantly decreased and the MDA level significantly increased after the flap elevation according to basal levels of untreated flaps. The mean flap survival rates in the exogenous SOD or glutathione (GSH)-treated groups were significantly increased with respect to the untreated group. The SOD level was increased significantly and the MDA level was decreased significantly in the SOD-or GSH-treated groups relative to the control group after the flap elevation. These results have suggested that ROS may have an important role in ischemic flow-through venous flap pathogenesis and additionally, antioxidants could enhance the rate of flap survival.
Glutathione disulphide as a marker of reperfusion injury in ischaemic skin flaps
British Journal of Plastic Surgery, 1995
Estimation of the oxidised form of glutathione (GSSG) in an ischaemic/reperfused organ is frequently employed as an indicator of oxidative stress created by the production of oxygen free radicals during the reperfusion period. The time course of oxidative stress and tissue damage in 19 ischaemic/reperfused guinea-pig island skin flaps was evaluated. No-flow ischaemia was induced in the flaps for 6 h in 7 animals, and for 8 h in 9 animals (a further 3 animals served as controls without ischaemia). Arterial and venous blood samples were obtained directly from the flap pedicle at baseline, 10,30, and 60 min following reperfusion. Results suggest that a second focus of oxidative injury, possibly mediated by activated neutrophils, contributes to the overall process of reperfusion injury. Plasma levels of GSSG allow for a more sensitive quantification of oxidant stress within reperfused ischaemic flaps, and may serve as a useful tool in skin flap research.