Sulfatide and Monoclonal Antibodies Prevent Reperfusion Injury in Skin Flaps

Abstract

Sulfatide binds to P- and L-selectin, which play important roles in the initiation of neutrophil–endothelial interactions. Sulfatide protects skin flaps from ischemia–reperfusion injury. The purpose of this study was to evaluate the augmented protection when anti-rat ICAM-1 and anti-rat LFA-1 antibodies are combined with sulfatide in the ischemia–reperfusion model of rat skin flaps. Sulfatide was administered intravenously just before elevation of the right abdominal epigastric flap, and monoclonal antibodies were injected 30 min before clamp release. The femoral artery and vein were clamped above and below the epigastric vessels for 11 h and then the clamp was released. The administration of both sulfatide and monoclonal antibodies significantly increased the flap surviving area (6.58 ± 0.61 cm2 versus the group with monoclonal antibodies alone, 4.43 ± 0.32 cm2, P = 0.01). In the untreated rats the area was 1.86 ± 0.36 cm2. Histological examination 24 h after reperfusion in the group treated with sulfatide and monoclonal antibodies showed only slight leukocyte invasion into the flap, and myeloperoxidase activity 24 h after reperfusion was significantly reduced. This study indicates that both sulfatide and monoclonal antibodies protect rat skin flaps from ischemia–reperfusion injury.