Department of Plastic and Reconstructive Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Institute of Scientific and Industrial Research, Osaka University, Osaka, Japan.
Sci Rep. 2022 Apr 13;12(1):6168. doi: 10.1038/s41598-022-10228-6.
Hydrogen is effective against ischemia-reperfusion (I/R) injury in skin flaps. However, the difficulty of continuously administering a sufficient amount of hydrogen using conventional methods has been an issue in the clinical application of hydrogen-based therapy. An Si-based agent administered orally was previously shown to continuously generate a large amount of hydrogen in the intestinal environment. In this study, we assessed the effect of the Si-based agent on the inhibition of I/R injury in skin flaps using a rat model. In the I/R groups, the vascular pedicle of the abdominal skin flap was occluded for three hours followed by reperfusion. In the I/R + Si group, the Si-based agent was administered perioperatively. After reperfusion, flap survival rate, blood flow, oxidative stress markers, inflammatory markers/findings, and degree of apoptosis were evaluated. Flap survival rate was significantly higher, and histological inflammation, apoptotic cells, oxidative stress markers, and levels of inflammatory cytokine mRNA and protein expression were significantly lower, in the I/R + Si group compared to the I/R group. The Si-based agent suppressed oxidative stress, apoptosis, and inflammatory reactions resulting from I/R injury, thereby contributing to improvements in skin flap survival.
氢气对皮瓣缺血再灌注（I/R）损伤有效。然而，使用传统方法持续给予足够量的氢气存在困难，这一直是基于氢气的治疗方法在临床应用中的一个问题。先前的研究表明，口服给予一种基于硅的试剂可以在肠道环境中持续产生大量氢气。在这项研究中，我们使用大鼠模型评估了基于硅的试剂对皮瓣 I/R 损伤抑制的作用。在 I/R 组中，腹部皮瓣的血管蒂夹闭 3 小时后再灌注。在 I/R+Si 组中，给予基于硅的试剂进行围手术期治疗。再灌注后，评估皮瓣存活率、血流量、氧化应激标志物、炎症标志物/发现、以及细胞凋亡程度。与 I/R 组相比，I/R+Si 组的皮瓣存活率显著更高，组织学炎症、凋亡细胞、氧化应激标志物以及炎症细胞因子 mRNA 和蛋白表达水平显著降低。基于硅的试剂抑制了 I/R 损伤引起的氧化应激、细胞凋亡和炎症反应，从而有助于改善皮瓣存活率。
