title: Microanalyses of enzymes and metabolites in ischemia/reperfusion-induced partial-thickness skin wounds.
abstract: A transition zone between well-perfused proximal tissue and inadequately perfused distal tissue was evaluated histologically and biochemically in skin flaps. Cranially based pedicle flaps, 3 x 7.5 cm, were made on the backs of female Sprague-Dawley rats. Flap survival was 22% of the original flap area at 7 days and 40% at 14 days after flap elevation (p < 0.001). The transition zone consisted of full-thickness skin survival proximally and partial-thickness wound distally. It is evident that skin wounds induced by ischemia or reperfusion repair continuously between 7 and 14 days after flap elevation. Tissue glucose, lactate, and hypoxanthine levels were measured to assess capillary perfusion in the transition zone on postoperative day 3. The proximal full-thickness skin 5 mm from the wound margin demonstrated no significant changes in glucose and lactate levels compared with normal skin. The partial-thickness wounds exhibited no change in glucose (a 33% decrease was not statistically significant) but a significant increase (319% of normal) in lactate level (p < 0.05). Hypoxanthine levels increased to 453% of normal in full-thickness skin (p < 0.01) and to 787% in partial-thickness wounds (p < 0.001). Metabolic response was evaluated by enzyme assays in the transition zone. Hexokinase activity increased by 251% of normal (p < 0.05), glucose 6-phosphate dehydrogenase by 245% (p < 0.01), and glutathione reductase by 184% (p < 0.05) in the proximal full-thickness skin. Hexokinase activity further increased by 482% of normal (p < 0.01), glucose 6-phosphate dehydrogenase by 379% (p < 0.05), and glutathione reductase by 346% (p < 0.01) in partial-thickness wounds. The results suggest that partial-thickness wounds have less capillary circulation but greater antioxidant enzyme activities than does the survival area with full-thickness skin.
authors.affiliation: Division of Plastic, Reconstructive, and Maxillofacial Surgery, The Johns Hopkins University School of Medicine, Baltimore, Md., USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Im
authors.forename: M F
authors.initials: MF
authors.lastname: Angel
authors.forename: C A
authors.initials: CA
authors.lastname: Vander Kolk
authors.forename: P N
authors.initials: PN
authors.lastname: Manson