Gribbe Orjan, Gustafsson Lars E, Wiklund N Peter
Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
Eur J Pharmacol. 2008 Jan 6;578(1):51-6. doi: 10.1016/j.ejphar.2007.09.032. Epub 2007 Oct 3.
Surgical flaps are commonly used in the reconstruction of tissue defects after tumour surgery and trauma. Flap failure continues to be a clinical problem and the underlying causes are not fully understood. In the present study a system that generates nitric oxide (NO) in a non-enzymatic fashion was created through the acidification with vitamin C of a cream containing increasing concentrations (0.125%, 0.25%, 0.5%, 1.25% and 2.5%) of nitrite (NO(2)(-)). The cream was applied for 30 min to a modified epigastric island skin flap in the rat. Blood flow in the supplying artery was measured by transit-time ultrasound flowmetry throughout the experiment and superficial skin blood flow was measured by laser Doppler perfusion imaging before and after treatment. Mean arterial blood pressure was also monitored. NO and the gas nitrogen dioxide (NO(2)), which is formed when NO reacts with atmospheric oxygen, were measured above the cream using chemiluminescence. In flaps treated with the NO generating cream, a concentration-dependent increase in blood flow in the supplying artery and flap skin of up to 130% was observed. Cream base alone or cream base acidified with vitamin C had no effect on blood flow. Also, concentration-dependent formation of both NO and NO(2) was seen. NO increases both supplying artery blood flow and superficial cutaneous blood flow in an epigastric island skin flap model in the rat indicating that NO is of importance in flap physiology and possibly also for flap survival.
手术皮瓣常用于肿瘤手术和创伤后组织缺损的重建。皮瓣坏死仍是一个临床问题，其潜在原因尚未完全明确。在本研究中，通过用维生素C酸化含有不同浓度（0.125%、0.25%、0.5%、1.25%和2.5%）亚硝酸盐（NO₂⁻）的乳膏，创建了一种以非酶方式产生一氧化氮（NO）的系统。将该乳膏应用于大鼠改良的上腹部岛状皮瓣30分钟。在整个实验过程中，通过渡越时间超声血流仪测量供应动脉的血流，并用激光多普勒灌注成像在治疗前后测量皮瓣表面皮肤血流。同时监测平均动脉血压。使用化学发光法测量乳膏上方的NO以及NO与大气中的氧气反应形成的二氧化氮（NO₂）。在用产生NO的乳膏处理的皮瓣中，观察到供应动脉和皮瓣皮肤的血流呈浓度依赖性增加，最高可达130%。单独的乳膏基质或用维生素C酸化的乳膏基质对血流没有影响。此外，还观察到NO和NO₂均呈浓度依赖性形成。在大鼠上腹部岛状皮瓣模型中，NO可增加供应动脉血流和皮瓣表面皮肤血流，这表明NO在皮瓣生理学中具有重要作用，可能对皮瓣存活也很重要。
