Einfluss des NO-Donors Spermine/Nitric Oxide Complex auf die Nekroserate von Lappenplastiken nach Ischämie am epigastrischen Lappenmodell der Ratte

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.