[Study of the effect of streptokinase and allopurinol in island skin flaps submitted to prolonged ischemia: experimental study in rats].
BACKGROUND
To establish a relation between the survival rate of island skin flaps submitted to prolonged ischemia and the effect of streptokinase and allopurinol administered after the ischemic period.


METHODS
A total of 48 male Winstar rats, each weighing between 300 and 350 grams,were separated into four groups of twelve as follows: control, allopurinol, streptokinase and association of allopurinol and streptokinase, were submitted to an epigastric island flap dissection followed by epigastric vessel bundle clamping. Flaps remained this way for 8 hours in normothermic mixed ischemia. After the ischemic period, clamps were removed and each rat received the therapeutical scheme proposed for the group by intravenous injections. Flap survival analysis was performed on the seventh post operative day. Variance and descriptive analyses (as a percentage of the necrotic area) as well as Dunnett-T3 multiple comparisons among the 4 groups and median tests were carried out.


RESULTS
Rats in the control group presented an average of 79.88% of necrosis in the flap total area; those which received allopurinol presented an average of 64.05% of necrosis whereas the group which received streptokinase showed an average of 55.52% of necrosis. With the association of both drugs, rats presented an average of 54.30% of necrosis in the flap total area. By applying Dunnet test and the median test, it could be verified that, in this study the streptokinase group had the lowest necrosis rate.


CONCLUSIONS
The systemic administration of streptokinase after 8 hours of normothermic global ischemia resulted in an increased survival rate of epigastric island skin flaps in rats, when compared to the administration of allopurinol, association of the two drugs and the control group.
Moura
Tatiana de
Td
Hospital das Clínicas, São Paulo, SP.
Marques
Ary de Azevedo
Ade A
Bernal
Sabrina Oliveira
SO
Gagliocca
Gustavo Damaggio
GD
Gemperli
Rolf
R
Ferreira
Marcus Castro
MC
D000493:Allopurinol / Q000494:pharmacology*; D000818:Animals; D004195:Disease Models, Animal; D004338:Drug Combinations; D004791:Enzyme Inhibitors / Q000494:pharmacology; D019074:Epigastric Arteries / Q000601:surgery; D005343:Fibrinolytic Agents / Q000494:pharmacology*; D006085:Graft Survival / Q000187:drug effects*; D007511:Ischemia / Q000150:complications* / Q000188:drug therapy; D008297:Male; D009336:Necrosis; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D015427:Reperfusion Injury / Q000517:prevention & control*; D013300:Streptokinase / Q000494:pharmacology*; D013524:Surgical Flaps / Q000098:blood supply* / Q000473:pathology
D004338:Drug Combinations; D004791:Enzyme Inhibitors; D005343:Fibrinolytic Agents; D000493:Allopurinol; D013300:Streptokinase