Küntscher M V, Juran S, Menke H, Gebhard M M, Erdmann D, Germann G
Department of Plastic and Hand Surgery, Burn Center, BG Trauma Center Ludwigshafen, Ludwigshafen, Germany.
Br J Plast Surg. 2002 Jul;55(5):430-3. doi: 10.1054/bjps.2002.3871.
Spermine/nitric oxide complex (Sper/NO) is a new nitric oxide (NO) donor with a long half-life providing controlled biological release of NO in vivo. The purpose of this study was to determine whether flap survival could be improved by pre-ischaemic or post-ischaemic intravenous administration of Sper/NO. We divided 37 male Wistar rats into four experimental groups. An extended epigastric adipocutaneous flap was raised in each animal. The mean area of flap necrosis was assessed for all groups on the fifth postoperative day, using planimetry software. The average area of flap necrosis was mean +/- s.d. = 68.2%+/-18.1% in the control group, and 29.7% +/- 13.3% in the non-ischaemic controls. The group with pre-ischaemic application of Sper/NO demonstrated an average flap necrosis of mean+/-s.d. = 11.2%+/-5.9%, whereas this increased to 59.2%+/-14.4% in the group receiving Sper/NO 5 min prior to reperfusion. The group with pre-ischaemic application of Sper/NO showed a significantly lower area of flap necrosis than either of the control groups or the group receiving Sper/NO just prior to reperfusion (P < 0.05). The group receiving Sper/NO just prior to reperfusion demonstrated a significantly higher mean area of flap necrosis than the non-ischaemic controls (P < 0.05), but did not differ significantly from the control group. Our data show that pharmacological preconditioning and enhancement of flap survival can be achieved by intravenous administration of Sper/NO. The application of Sper/NO at the end of the ischaemia period or in the early reperfusion period provides no protection against ischaemia-reperfusion injury.
精胺/一氧化氮复合物（Sper/NO）是一种新型一氧化氮（NO）供体，半衰期长，可在体内实现NO的可控生物释放。本研究旨在确定缺血前或缺血后静脉注射Sper/NO是否能提高皮瓣存活率。我们将37只雄性Wistar大鼠分为四个实验组。在每只动物身上掀起一个上腹延长型脂肪皮瓣。术后第5天，使用面积测量软件评估所有组皮瓣坏死的平均面积。对照组皮瓣坏死的平均面积为均值±标准差=68.2%±18.1%，非缺血对照组为29.7%±13.??%。缺血前应用Sper/NO的组皮瓣平均坏死率为均值±标准差=11.2%±5.9%，而在再灌注前5分钟接受Sper/NO的组这一比例增至59.2%±14.4%。缺血前应用Sper/NO的组皮瓣坏死面积显著低于对照组或再灌注前接受Sper/NO的组（P<0.05）。再灌注前接受Sper/NO的组皮瓣坏死平均面积显著高于非缺血对照组（P<0.05），但与对照组无显著差异。我们的数据表明，静脉注射Sper/NO可实现药理学预处理并提高皮瓣存活率。在缺血期末或再灌注早期应用Sper/NO不能提供针对缺血-再灌注损伤的保护作用。
