Abstract
The purpose of this study is to determine whether flap survival can be improved by pre- or post-ischemic intravenous application of Spermine/Nitric Oxide Complex (Sper/NO).Thirty-seven male Wistar rats were divided into four experimental groups. An extended epigastric adipo-cutaneous flap (6 x 10 cm) was raised. In one of the control groups (K, n = 10), a three hour flap ischemia was induced by clamping the pedicle. Another group served as a non-ischemic control (KO, n = 8). The animals of group Sl (n = 10) received 500 nmol/kg Sper/NO intravenously 30 min prior to ischemia. In group S2 (n = 9) an equivalent dose of Sper/NO was administered 5 min prior to reperfusion. Flap ischemia was induced in group Sl, and S2 as in control group K.Average flap necrosis area was 68.2% (± 18.1%) in the control group K, and 29.7% (± 13,3%) in the non-ischemic controls (KO). The group with pre-ischemic application of Sper/NO (Sl) demonstrated with an average flap necrosis of 11.2% (± 5.9%), whereas it was 59.2% (± 14.4%) in group S2. Group Sl showed a significantly lower flap necrosis area than the groups K, KO, and S2 (p < 0.05). Group S2 demonstrated a significantly higher mean flap necrosis area than the non-ischemic controls (p < 0.05). However, no significant difference could be shown between the groups S2 and K.Our data show, that pharmacological ischemic preconditioning, and enhancement of flap survival can be achieved by intravenous administration of Sper/NO. The application of Sper/NO at the end of the ischemic period provides no protection against ischemia-reperfusion injury.
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