The Effect of Antioxidants on Ischemia-Reperfusion Injury in Flap Surgery

Bozkurt, Mehmet; Sezgiç, Melihcan; Karakol, Perçin; Uslu, Can; Balikci, Tevfik

doi:10.5772/intechopen.85500

Cited by 9 publications

(5 citation statements)

References 77 publications

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“…Antioxidant agents such as αtocopherol, ascorbic acid, β-carotene, glutathione, coenzyme Q10, α-lipoic acid, and melatonin all have been shown to have positive effects on flap survival. 39 But large cohort studies to reveal the optimal dose or the superiority of these agents among each other do not exist.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Ischemic Preconditioning and Systemic Piracetam for Prevention of Ischemia-Reperfusion Injury in Musculocutaneous Flaps

Demiröz

Derebaşınlıoğlu

Ercan

et al. 2020

J Reconstr Microsurg

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Background Ischemia-reperfusion injury plays an important role in flap failure. Ischemic preconditioning technique is the only proven method for preventing ischemia-reperfusion injury, but it is not used widely in daily practice because of difficulties such as prolonging the operation time, need for surgical experience, and increasing the risk of complications. This study has been performed with the assumption that piracetam may be a simple and inexpensive alternative to the preconditioning technique due to its antioxidant, antiaggregant, rheological, anti-inflammatory, antiapoptotic, cytoprotective, and immune modulating effects. Methods Thirty-two rats were divided into four groups and latissimus dorsi musculocutaneous flaps were raised. No extra procedure was applied, and no treatment was given to the control group. Four hours of ischemia was created by clamping the thoracodorsal pedicle in the second group. The animals in the third group were treated with 10 minutes of ischemia and reperfusion periods as a preconditioning procedure before the 4 hours of ischemia. Animals in the fourth group received systemic piracetam 30 minutes before and 6 days after reperfusion. Nitric oxide and myeloperoxidase levels in serum and tissue, acute inflammatory cell response, and vascular proliferation in tissue were examined at the postoperative 24th hour and 10th day. Results Myeloperoxidase activity in both preconditioning and piracetam groups, was significantly lower than the ischemia-reperfusion group. Acute inflammatory cell response was similarly decreased in both preconditioning and piracetam groups compared with ischemia-reperfusion group. Tissue measurements of nitric oxide were also significantly higher in both preconditioning and piracetam groups than in the ischemia-reperfusion group. However, vascular proliferation increased in the preconditioning group, while it did not show any significant change in the piracetam group. Conclusion This study shows that systemic piracetam treatment provides protection against ischemia-reperfusion injury in musculocutaneous flaps and can offer a simple and inexpensive alternative to the preconditioning technique.

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Section: Discussionmentioning

confidence: 99%

Comparison of Ischemic Preconditioning and Systemic Piracetam for Prevention of Ischemia-Reperfusion Injury in Musculocutaneous Flaps

Demiröz

Derebaşınlıoğlu

Ercan

et al. 2020

J Reconstr Microsurg

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“…Animal studies are available showing the hypolipidemic and antidiabetic effects of cumin [78]. Experimental studies have been conducted to support the effect of cumin on renal ischemia-reperfusion injury [79,80]. It also has antibacterial and potent antimicrobial activity [66,77].…”

Section: Cumin (Cumin Aldehyde/cuminum Cyminum)mentioning

confidence: 99%

Use of Selected Antioxidant-Rich Spices and Herbs in Foods

Karakol¹,

Kapi²

2021

Antioxidants - Benefits, Sources, Mechanisms of Action

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Free radicals are chemicals that play a role in the etiopathogenesis of ischemia–reperfusion injury. To prevent or reduce this damage, many protective or therapeutic antioxidants are used effectively in alternative medicine. These antioxidants include immunological or pharmacological agents, vitamins, food and herbal products, and spices. Herbs and spices have been used for a long time as coloring or preservative agents by adding to the content of foods, and at the same time to increase the nutritional value of foods. More recently, the nutritional effects of herbs and spices have become more perceived and the area of interest for these products has increased. Concordantly, the biological contents of herbs and spices have begun to be studied in more detailed way at the cellular and molecular level. Sample plants are classified according to different chemical families, with the diet. Therefore, they have different levels of antioxidant capacity. These products also have potent anti-inflammatory, antihypertensive, glucoregulatory, antithrombotic, anticarcinogenic and so forth effects. These properties are used in the treatment of some chronic diseases. In this review, the antioxidant properties of various herbs and spices used to add flavor to foods or to extend their shelf life have been examined in the light of large-scale nutritional epidemiological studies, in vitro cellular/animal studies and clinical trials.

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“…Free radicals are responsible for these alterations, as they can lead to tissue necrosis and alter the structure and function of cells. 3 For I/R there are, three different therapeutic approaches that can be implemented. These approaches can be used either before, during, or after ischaemia.…”

Section: Introductionmentioning

confidence: 99%

Valproic acid and ivermectin increase GABA levels to improve the viability of skin flaps in rats

Pradnyandari,

Riasa

2024

Int J Res Med Sci

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Background: Gamma-aminobutyric acid (GABA) is a nonproteinogenic amino acid known as the main inhibitory neurotransmitter in the central nervous system. Ivermectin (IVM) and valproic acid (VA), both increase GABA levels. The purpose of this study was to determine the effect of VA and IVM on the viability of extended random-pattern skin flaps in Wistar rats and their GABA-dependent mechanisms. Methods: This experimental study used 32 Wistar rats that underwent surgery to have caudally based extended random-pattern skin flaps divided into four distinct groups. In the first group, 0.05 mg/kg IVM was administered via intraperitoneal (i.p.) injection 30 minutes (min) prior to elevating the flap. The second group was administered 100 mg/kg VA by i.p. injection 60 min prior to elevating the flap. The third group was administered VA 100 mg/kg followed by IVM 0.05 mg/kg injected (i.p.) 60 min and 30 min prior to flap elevation, respectively. The fourth group was used as a control. After 7 days, the percentage of flap viability was measured, and tissue sampling was performed to examine GABA levels. Results: It was found that the highest viability rate was in the group administered VA combined with IVM (93.98%) compared to all other groups (p<0.001). The highest GABA levels in the tissue were observed in the group administered VA combined with IVM (284.91 nmol/l) compared to all other groups (p<0.001). Conclusions: IVM in combination with VA improves the viability of extended random-pattern skin flaps by increasing GABA levels.

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The Effect of Antioxidants on Ischemia-Reperfusion Injury in Flap Surgery

Cited by 9 publications

References 77 publications

Comparison of Ischemic Preconditioning and Systemic Piracetam for Prevention of Ischemia-Reperfusion Injury in Musculocutaneous Flaps

Comparison of Ischemic Preconditioning and Systemic Piracetam for Prevention of Ischemia-Reperfusion Injury in Musculocutaneous Flaps

Use of Selected Antioxidant-Rich Spices and Herbs in Foods

Valproic acid and ivermectin increase GABA levels to improve the viability of skin flaps in rats

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