J Korean Assoc Maxillofac Plast Reconstr Surg.  2006 Jul;28(4):287-294.

Prevention of ischemia-reperfusion injury in rat skin island flap: comparison of histamine receptor blocking agents with l-arginine

• Seo YK
• Kim UK

Abstract

Vascular thrombosis and ischemic necrosis still remain the most significant threats to the survival of free flaps. To date, neutrophils have been implicated in the pathogenesis of postischemic injury. Several studies have demonstrated that modulating the neutrophil response to ischemia-reperfusion injury can decrease the extent of the injury. In addition, some authors noticed that mast cell counts were also increased in flaps exposed to state of ischemia/reperfusion. So, we designed to evaluate the role of mast cells in ischemia/reperfusion by blocking histamine and to compare the effect of Larginine, a nitric oxide precursor which is known to prevent neutrophil-mediated tissue injury. Epigastric island skin flaps were elevated in 30 rats and rendered ischemic. Thirty minutes prior to reperfusion, the rats were treated with intraperitoneal saline, diphenhydramine, cimetidine, and Larginine. The necrosis rate of flap at 7 days, the number of neutrophils and mast cells at 20 hours were evaluated. In conclusion, histamine receptor blockers as well as L-arginine significantly decreased flap necrosis in a rat skin island ischemia-reperfusion flap model, but the protective effect was not significantly different in both agent groups.

Keyword

Free flap; Ischemia; Reperfusion; Histamine receptor blocker; L-arginine

MeSH Terms

Animals
Arginine*
Cimetidine
Diphenhydramine
Free Tissue Flaps
Histamine*
Ischemia
Mast Cells
Necrosis
Neutrophils
Nitric Oxide
Rats*
Receptors, Histamine*
Reperfusion
Reperfusion Injury*
Skin*
Thrombosis
Arginine
Cimetidine
Diphenhydramine
Histamine
Nitric Oxide
Receptors, Histamine