Effects of various protocols of ischemic preconditioning on rat tram flaps

Wang, Honggang; Li, Zhiyong; Liu, Xiaolin

doi:10.1002/micr.20436

Cited by 19 publications

(8 citation statements)

References 35 publications

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“…In another study where three cycles of ischaemia and reperfusion were applied, the authors reported that the survival rate of the flaps increased with 16% [16]. Ischaemic preconditioning could improve the viability of musculocutaneous flaps and two and three cycles of ischaemic preconditioning with a 10/5-minute combination were more effective than a single cycle of ischaemic preconditioning [17]. Furthermore, the results of a recently published study have suggested that the optimal time for ischaemic preconditioning is 3 days before the flap elevation in a flap operation [18].…”

Section: Discussionmentioning

confidence: 97%

Comparison of ischaemic preconditioning with surgical delay technique to increase the viability of single pedicle island venous flaps: An experimental study

Ceylan¹,

Kaya

Çaydere

et al. 2014

Journal of Plastic Surgery and Hand Surgery

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The aim of the present study was to investigate the effect of ischaemic preconditioning compared with the surgical delay procedure in an effort to increase the survival rate of single pedicle island venous flaps. Eighteen male Wistar albino rats (250-350 g) were included. A 3 × 4 cm flap was planned at the right lower abdomen of the rat. Superficial epigastric vein constituted the pedicle of the flap. The rats were divided into three groups, each consisting of six rats. In the control group, a single pedicle venous island flap was elevated on each rat and no other surgical procedure was performed. In the ischaemic preconditioning group, ischaemic preconditioning was performed and, in the surgical delay procedure group, the surgical delay technique was performed before flap elevation. The mean necrosis areas were 56.85 ± 14.60%, 28.73 ± 15.60%, and 12.08 ± 3.65% in the control, ischaemic preconditioning, and surgical delay procedure groups, respectively. The necrosis areas were significantly smaller in the ischaemic preconditioning group and surgical delay procedure groups compared to the control group (p = 0.004 and p < 0.001, respectively). The necrosis areas were similar in the ischaemic preconditioning and surgical delay procedure groups. Histopathological parameters including necrosis, abscess formation, and skin ulceration scores were significantly lower in the ischaemic preconditioning group than in the control group, whereas the study groups were similar. In conclusion, ischaemic preconditioning may serve as an adjuvant technique in increasing venous island flap viability.

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Section: Discussionmentioning

confidence: 97%

Comparison of ischaemic preconditioning with surgical delay technique to increase the viability of single pedicle island venous flaps: An experimental study

Ceylan¹,

Kaya

Çaydere

et al. 2014

Journal of Plastic Surgery and Hand Surgery

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“…I/R injury is classified as either primary or secondary in the context of plastic surgery. In free flap surgery, the time between removal of the flap from the donor area and commencement of reperfusion is termed “primary ischemia,” and ischemia developing after a flap is placed is termed “secondary ischemia.” The latter type of ischemia is of greater concern in flap surgery, and the effect of ischemic conditioning on I/R injury has been investigated previously . Only a single report on I/R injury has appeared; the ischemia spared the three perforators of a deep inferior epigastric perforator flap.…”

Section: Discussionmentioning

confidence: 99%

“…21 The latter type of ischemia is of greater concern in flap surgery, and the effect of ischemic conditioning on I/R injury has been investigated previously. 1,[19][20][21][22] Only a single report on I/R injury has appeared; the ischemia spared the three perforators of a deep inferior epigastric perforator flap. 23 In this study, we used cranial epigastric perforator flap that was described by Okşar et al firstly, 17 then showed as a true perforator flap model by Hallock and Rice.…”

Section: Discussionmentioning

confidence: 99%

The effect of mesenchymal stem cells and sildenafil on flap viability in perforator‐based flaps for ischemia/reperfusion injury: An experimental study

et al. 2015

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In this rat pedicled perforator based abdominal flap, we found that after primary ischemia, application of MSCs and SC, either individually or in combined form, significantly enhanced antioxidant enzyme levels compared with those in the control group, and provided protection against ischemia/reperfusion injury. The two treatments acted synergistically to protect against damage after 4 hours of ischemia, but either treatment alone more effectively enhanced viable flap area after 8 hours of ischemia, although some flap damage was apparent. © 2015 Wiley Periodicals, Inc. Microsurgery 36:402-409, 2016.

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“…10 One study demonstrated that vascular delay in flaps improved survival 2.5-3 times over the control. 11…”

Section: Discussion Vascular Delay -Reconstructive Surgery Perspectivementioning

confidence: 99%

The Delay Phenomenon: A Compilation of Knowledge across Specialties

Hamilton

Wolfswinkel

Weathers

et al. 2014

Craniomaxillofacial Trauma & Reconstruction

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Objective The purpose of this article is to review and integrate the available literature in different fields to gain a better understanding of the basic physiology and optimize vascular delay as a reconstructive surgery technique. Methods A broad search of the literature was performed using the Medline database. Two queries were performed using "vascular delay," a search expected to yield perspectives from the field of plastic and reconstructive surgery, and "ischemic preconditioning," (IPC) which was expected to yield research on the same topic in other fields. Results The combined searches yielded a total of 1824 abstracts. The "vascular delay" query yielded 76 articles from 1984 to 2011. The "ischemic preconditioning" query yielded 6534 articles, ranging from 1980 to 2012. The abstracts were screened for those from other specialties in addition to reconstructive surgery, analyzed potential or current uses of vascular delay in practice, or provided developments in understanding the pathophysiology of vascular delay. 70 articles were identified that met inclusion criteria and were applicable to vascular delay or ischemic preconditioning. Conclusion An understanding of IPC's implementation and mechanisms in other fields has beneficial implications for the field of reconstructive surgery in the context of the delay phenomenon. Despite an incomplete model of IPC's pathways, the anti-oxidative, anti-apoptotic and anti-inflammatory benefits of IPC are well recognized. The activation of angiogenic genes through IPC could allow for complex flap design, even in poorly vascularized regions. IPC's promotion of angiogenesis and reduction of endothelial dysfunction remain most applicable to reconstructive surgery in reducing graft-related complications and flap failure.

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Effects of various protocols of ischemic preconditioning on rat tram flaps

Cited by 19 publications

References 35 publications

Comparison of ischaemic preconditioning with surgical delay technique to increase the viability of single pedicle island venous flaps: An experimental study

Comparison of ischaemic preconditioning with surgical delay technique to increase the viability of single pedicle island venous flaps: An experimental study

The effect of mesenchymal stem cells and sildenafil on flap viability in perforator‐based flaps for ischemia/reperfusion injury: An experimental study

The Delay Phenomenon: A Compilation of Knowledge across Specialties

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