The impact of lidocaine on flap survival following reperfusion injury.
BACKGROUND
Inflammatory events triggered by the mediators released from free oxygen radicals and infiltrated leukocytes play a direct role in formation of the ischemia-reperfusion (IR) injury. The aim of this study was to investigate the impact of lidocaine on IR injury due to its anti-inflammatory properties.


METHODS
Following delivery of lidocaine to the ischemic flaps in two different doses prior to the reperfusion, flap survival, malondialdehyde (MDA) level, myeloperoxidase (MPO) level, neutrophil count, and measurement of vascular diameters were studied. Twelve hours after reperfusion, tissue specimens were collected for measurement of MDA level, MPO level, neutrophil count, and vascular diameters. Flap survival was evaluated on the fifth day.


RESULTS
Flap survival rate was 15.54% ± 8.23% in the control group, whereas the groups treated wtih lidocaine showed remarkable elevations in survival rates as follows: 70.83% ± 33.53% and 67.42% ± 30.81%, respectively. MDA levels in sham and lidocaine treatment groups were significantly lower than those observed in control group.


CONCLUSIONS
Lidocaine inhibited the increase in MDA level associated with IR injury while showing no influence over increases in number of neutrophils and tissue MPO level, and it elevated the flap survival rate.
Eskitascioglu
Teoman
T
Department of Plastic, Reconstructive and Aesthetic Surgery, Erciyes University, Faculty of Medicine, Kayseri, Turkey. teoman@erciyes.edu.tr
Karaci
Selman
S
Canoz
Ozlem
O
Kılıc
Eser
E
Gunay
Galip K
GK
D000818:Animals; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D008012:Lidocaine / Q000494:pharmacology / Q000627:therapeutic use*; D008315:Malondialdehyde / Q000378:metabolism; D023421:Models, Animal; D009336:Necrosis; D009504:Neutrophils / Q000187:drug effects / Q000473:pathology; D009195:Peroxidase / Q000378:metabolism; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control*; D013524:Surgical Flaps / Q000098:blood supply* / Q000473:pathology / Q000502:physiology*
D000893:Anti-Inflammatory Agents; D008315:Malondialdehyde; D008012:Lidocaine; D009195:Peroxidase