General session V Moderated by Yashihiko Maehara: Reduction of Ischemia‐Reperfusion Injury to Skin Flaps by Monoclonal Antibody to Leukocyte Endothelial Adhesion Molecule‐1

Abstract

Aim: Ischemia‐reperfusion (I‐R) injury continues to be a problem for successful free tissue transfer and replantation after prolonged periods of ischemia. It has been shown that leukocytes and vascular endothelial cells release a variety of inflammatory mediators during reperfusion after ischemia. The leukocyte endothelial adhesion molecule‐1 (LECAM‐1) is a ligand on the endothelium for some of the adhesion receptors on leukocytes. The purpose of this study was to evaluate the blockage of leukocyte‐endothelial adhesion by a monoclonal antibody (MAb) to LECAM‐1 in skin flaps to prevent I‐R injury in rats.Methods: Male SD rats (225–250 g) were used. A skin flap (45 × 30 mm) supplied by the superficial epigastric A&V including the femoral vessels was isolated unilaterally. The femoral vessels were cross‐clamped the epigastric vessels for 9 hours of ischemia. Animals in treated group received MAb to LECAM −1 i.v. 15 minutes prior to reperfusion; those in the control group received normal saline. Skin flap viability was assessed by tracing the outline of viable and nonviable areas. Data were collected for the following 7 days. These data were corroborated with histological evidence on comparable areas of the flap.Results: Tracing analysis revealed average flap survival area of about 90% in treated group and about 20% in control group (p < 0.05). Histopathologically, few inflammatory changes could be observed in treated group, while marked damage was observed in control group.Conclusions: From this study, we concluded that treating skin flaps with Mab to LECAM ‐1 was effective for I‐R injury after 9 hours of warm ischemia.