Cold storage of rat skeletal muscle free flaps and pre-ischemic perfusion with modified UW solution.
We used the rat medial gastrocnemius free flap, based on a pedicle of the femoral artery and vein, in order to test the tolerance of skeletal muscle to cold ischemia-reperfusion (IR) injury, and to determine whether tolerance can be enhanced by pre-ischemic perfusion with tissue/organ preservation solutions. Muscle flaps (n = 6 per group) were subjected to variable periods of cold storage (0, 1, 2, 3, or 4 days) and 24-h normothermic reperfusion. Muscle viability, as determined by nitroblue tetrazolium (NBT) histochemical staining of viable mitochondria and supported by histological examination, was 100%, 26%, 11%, 4%, and 1%, respectively. Using 24-h cold storage/24-h reperfusion as the experimental conditions, groups of muscle flaps (n = 5 per group) were perfused immediately before cold storage with either modified, colloid-free University of Wisconsin (UW) solution, a solution described by Kohout et al. (Br J Plast Surg 1995;48:132-144) or normal saline. Perfusion with modified UW solution or Kohout's solution increased survival to 33% (P < 0.05) and 28% (not statistically significant), respectively, compared with the 19% viability of separate groups of nonperfused or saline-perfused controls. These findings indicate that cold-stored skeletal muscle is highly susceptible to cold IR injury and that the viability can be increased by prior perfusion with a tissue preservation solution such as modified UW solution.
Wagh
M
M
Bernard O'Brien Institute of Microsurgery, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
Pantazi
G
G
Romeo
R
R
Hurley
J V
JV
Morrison
W A
WA
Knight
K R
KR
D000241:Adenosine; D000493:Allopurinol; D000818:Animals; D003080:Cold Temperature; D005978:Glutathione; D007328:Insulin; D019194:Ischemic Preconditioning; D008297:Male; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000473:pathology / Q000637:transplantation*; D019188:Organ Preservation Solutions; D010477:Perfusion; D011887:Raffinose; D051381:Rats; D017207:Rats, Sprague-Dawley; D013524:Surgical Flaps; D013997:Time Factors
D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose