The effect of prior elevation of skin flaps and ischemia on blood thromboxane levels.
The physiological factors that allow for the survival of ischemic skin flaps have not been clearly elucidated. Previous work by others has shown that elevation of a flap 24 hours before an episode of complete ischemia significantly improved survival, presumably by delaying the onset of the no-reflow phenomenon. The current study, using an epigastric flap, investigated the role of thromboxane in these events by observing postischemic plasma levels of thromboxane B2, the stable metabolite of the short-lived thromboxane A2. Acutely ischemic flaps were compared with those elevated 24 hours before ischemia. After the ischemic insult, blood was drawn from the venous effluent of the flaps. Thromboxane levels after 4 hours of ischemia were significantly decreased (p less than 0.001) in the postischemic period in those flaps elevated 24 hours before ischemia compared with flaps that had undergone ischemia acutely. Moreover, acutely ischemic flaps had significantly more thromboxane than nonischemic controls (p less than 0.001). These results confirm the importance of thromboxane metabolism in the no-reflow phenomenon.
Angel
M F
MF
Microsurgery Research Centre, St. Vincent's Hospital, Melbourne, Victoria, Australia.
Knight
K R
KR
Mellow
C G
CG
Morrison
W A
WA
O'Brien
B M
BM
D000818:Animals; D007511:Ischemia / Q000097:blood*; D011817:Rabbits; D011863:Radioimmunoassay; D012867:Skin / Q000098:blood supply*; D013524:Surgical Flaps; D013929:Thromboxane B2 / Q000097:blood*; D013997:Time Factors
D013929:Thromboxane B2