Ischemic Preconditioning (IPC) with Resveratrol on Epigastric Rat Flap

Abstract

Objectives: Investigate the effects of ischemic preconditioning (IPC) plus resveratrol on the viability of epigastric rat flaps for reconstructive microsurgery. Methods: Fifteen Sprague-Dawley rats were used from September 2011 to December 2011. Superficial epigastric artery- and vein-based island flaps (control flap and resveratrol flap) were used. IPC was applied to both flaps for 60 minutes. Therefore we administered 0.2 cc of resveratrol in the artery of the resveratrol Flap. On day 14, viable flap areas were measured, and taken for histological examinations with hematoxylin-eosin staining and CD34+ hematopoietic progenitor cells analysis. Results: We described destruction of skin and subcutaneous tissues in all control flaps, with hypoxic and ischemic areas and exudative phlogosis. The CD34 analysis was negative. The resveratrol flaps description was completely different. The necrosis and the acute inflammation were minimal. Instead, there was an important angiogenesis. Three rat flaps failed. However, there was angiogenesis also in the failed flaps, although reduced. In all resveratrol flaps there was large lymphoplasmacytic infiltrate, typical of chronic reparative processes, a good indicator of the end of acute inflammatory process. Conclusions: The IPC and the resveratrol made a significant contribution to the flap viability. The results of this study will contribute to the literature about the hemodynamics of rat flaps and guide further studies on the issue for the free flap in the reconstructive microsurgery.