Arch Plast Surg.  2017 Sep;44(5):384-389. 10.5999/aps.2017.44.5.384.

Effects of Remote Ischemic Conditioning Methods on Ischemia-Reperfusion Injury in Muscle Flaps: An Experimental Study in Rats

Affiliations
  • 1Department of Plastic, Reconstructive and Aesthetic Surgery, Yuksek Ihtisas University, Ankara, Turkey. durdaneergun@gmail.com
  • 2Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey.
  • 3Department of Plastic Reconstructive and Aesthetic Surgery, Namik Kemal University, Tekirdag, Turkey.
  • 4Department of Pathology, Ankara Numune Training and Research Hospital, Ankara, Turkey.
  • 5Department of Biochemistry, Ankara Numune Training and Research Hospital, Ankara, Turkey.

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 ischemia-reperfusion injury in muscle flaps.

Keyword

Ischemic preconditioning; Reperfusion injury; Ischemia

MeSH Terms

Animals
Extremities
Ischemia
Ischemic Preconditioning
Latex
Methods*
Nitric Oxide
Rats*
Reperfusion Injury*
Tourniquets
Latex
Nitric Oxide
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