The impact of ischemic postconditioning on ischemic skin flap injuries.

UNLABELLED  Ischemic postconditioning (IPOC) is a useful manipulation to reduce the undesirable effects of ischemia-reperfusion (IR) injury. The effects of IPOC were studied in an axial pattern skin flap model. METHODS The skin flaps of 40 rabbits were randomly divided into four groups. Ischemic postconditioning was performed using six 10-second cycles of repeated ischemia/reperfusion periods. The animals were al- located into four groups: group 1 (control); group 2 (ischemia); group 3 (postconditioning); group 4 (postconditioning 10 minutes later). Flap viability was assessed 1 week after the operation. The surviving flap area was recorded as a percentage of the entire flap area. Fisher's least significant difference (LSD) test was used for statistical analysis among different groups to evaluate the effects of ischemic preconditioning against ischemia. RESULTS The mean ± SD of surviving flap areas for groups 1, 2, 3, and 4 were 97.86 ± 0.62, 31.64 ± 1.04, 48.95 ± 0.82, and 30.01 ± 1.12, respectively. Statistical difference did not exist between group 2 and 4, but they were statistically different (P < 0.05) when compared to group 1 or group 3. CONCLUSION Ischemic postconditioning has a protective effect on ischemic flaps, but post- conditioning should be performed just after the ischemic event. .

[1]  Hong-chul Lim,et al.  Postconditioning attenuates ischemia‐reperfusion injury in rat skin flap , 2008, Microsurgery.

[2]  R. Guyton,et al.  Inhibition of myocardial injury by ischemic postconditioning during reperfusion: comparison with ischemic preconditioning. , 2003, American journal of physiology. Heart and circulatory physiology.

[3]  E. Kargı,et al.  Dual Preconditioning: Effects of Pharmacological Plus Ischemic Preconditioning on Skin Flap Survival , 2003, Annals of plastic surgery.

[4]  H. Matsumura,et al.  Preconditioning of the distal portion of a rat random-pattern skin flap. , 2001, British journal of plastic surgery.

[5]  W. Welch,et al.  Hsp72 Induction: A Potential Molecular Mediator of the Delay Phenomenon , 2000, Annals of plastic surgery.

[6]  J. W. Futrell,et al.  Preoperative cooling and warming of the donor site increase survival of skin flaps by the mechanism of ischaemic preconditioning: an experimental study in rats. , 1999, Scandinavian journal of plastic and reconstructive surgery and hand surgery.

[7]  J. Roake,et al.  The molecular and cellular basis of reperfusion injury following organ transplantation , 1998 .

[8]  P. Cederna,et al.  The Effect of the Delay Phenomenon on the Vascularity of Rabbit Abdominal Cutaneous Island Flaps , 1997, Plastic and reconstructive surgery.

[9]  R. Khouri Avoiding free flap failure. , 1992, Clinics in plastic surgery.

[10]  W. Koenig,et al.  Improving Acute Skin‐Flap Survival Through Stress Conditioning Using Heat Shock and Recovery , 1992, Plastic and reconstructive surgery.

[11]  R. Dunn,et al.  Flap models in the rat: a review and reappraisal. , 1992, Plastic and reconstructive surgery.

[12]  C. Forrest,et al.  Pharmacological Augmentation of Skin Flap Viability: A Hypothesis to Mimic the Surgical Delay Phenomenon or a Wishful Thought , 1989, Annals of plastic surgery.