Effect of high-energy phosphates and free radical scavengers on replant survival in an ischemic extremity model.
In replantation surgery, preoperative and intraoperative ischemia can lead to irreversible changes that prevent reperfusion during the subsequent re-establishment of circulation. These changes are termed the no-reflow phenomenon. Ischemic phase damage was addressed by comparing the dose-response effects of controls vs. five different high-energy phosphate compounds on replanted limb survival. Reperfusion damage was evaluated via comparisons of controls with superoxide dismutase (SOD). Ischemic hindlimbs treated with high-energy phosphates displayed improved survival compared with controls. Limbs treated with SOD demonstrated no change in survival at 4 hours and improved survival at 8 hours. Combining adenosine and SOD had no improved effect on survival. Adenosine was the most effective high-energy phosphate in limiting ischemic damage. The free radical scavenger (SOD) was beneficial only at the later stages of ischemia. In this experimental model, there appears to be a role for both phosphates and free radical scavengers in enhancing ischemic tissue survival.
Ablove
R H
RH
Division of Hand Surgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, USA.
Moy
O J
OJ
Peimer
C A
CA
Severin
C M
CM
Sherwin
F M
FM
D000241:Adenosine / Q000494:pharmacology; D000255:Adenosine Triphosphate / Q000494:pharmacology; D000818:Animals; D004305:Dose-Response Relationship, Drug; D016166:Free Radical Scavengers / Q000494:pharmacology*; D005635:Fructosediphosphates / Q000494:pharmacology; D006614:Hindlimb / Q000098:blood supply; D009243:NAD / Q000494:pharmacology; D010755:Organophosphates / Q000494:pharmacology*; D010725:Phosphocreatine / Q000494:pharmacology; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000517:prevention & control*; D012092:Replantation; D013482:Superoxide Dismutase / Q000494:pharmacology*
D016166:Free Radical Scavengers; D005635:Fructosediphosphates; D010755:Organophosphates; D010725:Phosphocreatine; D009243:NAD; D000255:Adenosine Triphosphate; D013482:Superoxide Dismutase; D000241:Adenosine; C029063:fructose-1,6-diphosphate