Sulfatide protects rat skin flaps against ischemia-reperfusion injury.

Monoclonal antibodies to adhesion molecules have been used in many trials to prevent ischemia-reperfusion injury. Sulfatide reacts strongly with P- and L-selectin, which play an important role in the initiation of neutrophil-endothelial interactions occurring in injured or inflamed tissues. The purpose of this study was to evaluate the effect of sulfatide on ischemia-reperfusion injury of the rat skin flap. Sulfatide was administered intravenously just before elevation of the right abdominal epigastric flap. The femoral artery and vein were clamped above and below the epigastric vessels for 10 or 11 h and then the clamp was released. Administration of sulfatide augmented significantly the flap area surviving in the 10-h ischemic model (7.18 +/- 0.47 cm2 versus control 5.15 +/- 0.39 cm2. P = 0.01). In the 11-h ischemic model the area was 4.59 +/- 0. 36 cm2 versus control 1.73 +/- 0.31 cm2 (P = 0.001). The ATP levels in the flap gradually increased after release of the clamp in the rat administered sulfatide, and the increase was significant at 48 h (P = 0.006). Histological examination 48 h after surgery showed greater leukocyte invasion into the control flap than into the flap of the rat administered sulfatide. Myeloperoxidase activity was significantly reduced 48 h after reperfusion in the 11-h ischemic model. This study indicates that sulfatide has a significant protective effect against ischemia and reperfusion in rat epigastric flaps.