Department of Aesthetic Plastic and Reconstructive Surgery, Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara, Turkey.
Department of Aesthetic Plastic and Reconstructive Surgery, Memorial Hospital, Kayseri, Turkey.
J Surg Res. 2021 May;261:282-292. doi: 10.1016/j.jss.2020.12.035. Epub 2021 Jan 18.
Ischemia-reperfusion injury has been one of the culprits of tissue injury and flap loss after island flap transpositions. Thus, significant research has been undertaken to study how to prevent or decrease the spread of ischemia-reperfusion injury. Preventive effects of β-glucan on ischemia-reperfusion injury in the kidney, lung, and small intestine have previously been reported. In this study, we present the ameliorating effects of β-glucan on ischemia-reperfusion injury using the epigastric artery island-flap in rats.
Thirty Wistar-Albino rats were equally divided into three groups: sham, experimental model, and treatment groups. In the sham group, an island flap was elevated and sutured back to the original position without any ischemia. In the experimental model group, the same-sized flap was elevated and sutured back with 8 h of ischemia and consequent 12 h of reperfusion. In the treatment group, 50 mg per kilogram β-glucan was administered to the rats using an orogastric tube for 10 d before the experiment. The same-sized flap is elevated and sutured back to its original position with 8 h of ischemia and 12 h of consequent reperfusion in the treatment group. Tissue biopsies were taken on the first day of the experimental surgery. Tissue neutrophil aggregation and vascular responses were evaluated by histological examinations. Tissue oxidant and antioxidant enzyme levels are evaluated biochemically after tissue homogenization. Topographic follow-up and evaluation of the flaps were maintained, and photographs were taken on the first and seventh day of the experimental surgery.
Topographic flap survival was significantly better in the β-glucan administered group. The neutrophil number, malondialdehyde, and myeloperoxidase levels were significantly lower while glutathione peroxidase and superoxide dismutase levels were significantly higher in the β-glucan administered group respective to the experimental model group.
Based on the results of our study, we can conclude that β-glucan is protective against ischemia-reperfusion injury. Our study presents the first experimental evidence of such an effect on skin island flaps.
缺血再灌注损伤是组织损伤和皮瓣失活的罪魁祸首之一。因此，人们进行了大量研究，以研究如何预防或减少缺血再灌注损伤的扩散。先前已经报道了β-葡聚糖对肾、肺和小肠缺血再灌注损伤的预防作用。在这项研究中，我们展示了β-葡聚糖在大鼠腹壁动脉岛状皮瓣缺血再灌注损伤中的改善作用。
30 只 Wistar-Albino 大鼠等分为三组：假手术组、实验模型组和治疗组。在假手术组中，皮瓣被抬高并缝合回原来的位置，没有任何缺血。在实验模型组中，同样大小的皮瓣被抬高并缝合回原来的位置，同时进行 8 小时的缺血和随后的 12 小时再灌注。在治疗组中，在实验前 10 天，通过经口管给予大鼠 50mg/kg 的β-葡聚糖。在治疗组中，同样大小的皮瓣被抬高并缝合回原来的位置，同时进行 8 小时的缺血和随后的 12 小时再灌注。在实验手术的第一天，取组织活检。通过组织学检查评估组织中性粒细胞聚集和血管反应。通过组织匀浆后生物化学评估组织氧化剂和抗氧化酶水平。对皮瓣进行形态学随访和评估，并在实验手术的第 1 天和第 7 天拍摄照片。
给予β-葡聚糖的皮瓣在形态上的存活率明显更高。与实验模型组相比，给予β-葡聚糖的皮瓣中性粒细胞数量、丙二醛和髓过氧化物酶水平显著降低，而谷胱甘肽过氧化物酶和超氧化物歧化酶水平显著升高。
根据我们的研究结果，我们可以得出结论，β-葡聚糖对缺血再灌注损伤具有保护作用。我们的研究首次提供了关于这种对皮肤岛状皮瓣的作用的实验证据。
