Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Effects of Remote Ischemic Conditioning Methods on Ischemia-Reperfusion Injury in Muscle Flaps: An Experimental Study in Rats

  • Keskin, Durdane (Department of Plastic, Reconstructive and Aesthetic Surgery, Yuksek Ihtisas University) ;
  • Unlu, Ramazan Erkin (Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara Numune Training and Research Hospital) ;
  • Orhan, Erkan (Department of Plastic Reconstructive and Aesthetic Surgery, Namik Kemal University) ;
  • Erkilinc, Gamze (Department of Pathology, Ankara Numune Training and Research Hospital) ;
  • Bogdaycioglu, Nihal (Department of Biochemistry, Ankara Numune Training and Research Hospital) ;
  • Yilmaz, Fatma Meric (Department of Biochemistry, Ankara Numune Training and Research Hospital)
  • Received : 2017.03.04
  • Accepted : 2017.08.29
  • Published : 2017.09.15
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Abstract

Background The aim of this study was to investigate the effects of remote ischemic conditioning on ischemia-reperfusion injury in rat muscle flaps histopathologically and biochemically. Methods Thirty albino rats were divided into 5 groups. No procedure was performed in the rats in group 1, and only blood samples were taken. A gracilis muscle flap was elevated in all the other groups. Microclamps were applied to the vascular pedicle for 4 hours in order to achieve tissue ischemia. In group 2, no additional procedure was performed. In groups 3, 4, and 5, the right hind limb was used and 3 cycles of ischemia-reperfusion for 5 minutes each (total, 30 minutes) was applied with a latex tourniquet (remote ischemic conditioning). In group 3, this procedure was performed before flap elevation (remote ischemic preconditoning). In group 4, the procedure was performed 4 hours after flap ischemia (remote ischemic postconditioning). In group 5, the procedure was performed after the flap was elevated, during the muscle flap ischemia episode (remote ischemic perconditioning). Results The histopathological damage score in all remote conditioning ischemia groups was lower than in the ischemic-reperfusion group. The lowest histopathological damage score was observed in group 5 (remote ischemic perconditioning). Conclusions The nitric oxide levels were higher in the blood samples obtained from the remote ischemic perconditioning group. This study showed the effectiveness of remote ischemic conditioning procedures and compared their usefulness for preventing ischemiareperfusion injury in muscle flaps.

Keywords

References

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