Abstract
Oxygen-derived free radicals have been implicated in the causation of cellular injury during low-flow ischemia and during reperfusion of previously completely ischemic tissue; they are also believed to be the causative factor in the no-reflow phenomena. Modulation of these free radical substances has been suggested as a means of decreasing the amount of tissue loss due to ischemia and subsequent reperfusion. Pretreatment of tissues with a variety of agents has been reported to minimize the production of oxygen radicals and augment tissue survival after an ischemic insult. Further evidence of free radical involvement in skin flap necrosis in a rat groin island skin flap model is presented. In addition, the effects of two different free radical scavengers, alpha tocopherol (20 mg/kg intraperitoneally once daily for a week) and ginkgo biloba (5 mg/kg orally twice a day for a week) have been investigated and compared. Since malonyldialdehyde (MDA) is the end product of lipoperoxidation which occurs in cellular membranes in an ischemic period - dependent manner, MDA levels in tissue homogenates were measured 60, 90, and 120 min after an ischemic insult. MDA levels significantly increased in a time-dependent manner during the ischemic period in the control group. Results from the determination of tissue MDA levels at biopsy sites of radical scavenger treated groups compared with the placebo group showed that the ginkgo biloba-treated rat samples had significantly lower MDA levels than control samples only at the 120 min ischemic period (p<0.01). However, protection of lipoperoxidation in alpha tocopherol-treated rat samples was detected after both the 90 and 12 min ischemic periods (p<0.01), and the magnitude of these decreased MDA levels in alpha tocopherol-treated samples was found to be greater than it was after ginkgo biloba treatment. Decreasing free radicals during reperfusion by using these agents, preferably alpha tocopherol, may be beneficial in modulating the no-reflow phenomenon and subsequent reperfusion injury, and may help to improve tissue salvage.
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