title: Effect of systemic piracetam treatment on flap survival and vascular endothelial growth factor expression after ischemia-reperfusion injury.
abstract: The effects of piracetam on flap survival, ischemia-reperfusion (I/R) injury, and vascular endothelial growth factor (VEGF) expression were evaluated in this study. Unipedicled epigastric flap model was used in 36 rats and was evaluated within 4 groups. The flap was elevated and untreated in Group 1. Postoperative piracetam treatment was given for 7 days in Group 2. In Group 3, 4 hours of ischemia and 2 hours of reperfusion were applied. I/R was applied to Group 4 and piracetam was given 30 minutes before reperfusion and postoperatively for 7 days. Laser Doppler flowmetry was used to measure blood flow changes. VEGF expression was determined using immunohistochemical methods on tissue samples taken after the completion of 2 hours reperfusion in groups 3 and 4. Flap necrosis was measured on the day 7 in all groups. Blood flow rates did not show significant difference between piracetam treated and untreated I/R groups. Piracetam significantly reduced necrosis area both in ischemic and nonischemic flaps ( P < 0.05). VEGF expression was significantly increased in piracetam-treated Group 4 compared with Group 3 ( P = 0.005). This experimental study demonstrates that systemic piracetam treatment improves survival of pedicled flaps, reduces necrosis amounts, and increases VEGF expression in I/R induced flaps.
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, Gazi University Faculty of Medicine, Ankara, Turkey. serhantuncer74@yahoo.com
authors.forename: Serhan
authors.initials: S
authors.lastname: Tuncer
authors.forename: Suhan
authors.initials: S
authors.lastname: Ayhan
authors.forename: Kemal
authors.initials: K
authors.lastname: Findikcioglu
authors.forename: Hakan
authors.initials: H
authors.lastname: Ergun
authors.forename: Ilhan
authors.initials: I
authors.lastname: Tuncer
mesh_terms: D000818:Animals; D006085:Graft Survival / Q000187:drug effects*; D007150:Immunohistochemistry; D017078:Laser-Doppler Flowmetry; D008297:Male; D023421:Models, Animal; D009336:Necrosis; D018696:Neuroprotective Agents / Q000494:pharmacology*; D010889:Piracetam / Q000494:pharmacology*; D051381:Rats; D017208:Rats, Wistar; D012039:Regional Blood Flow / Q000187:drug effects; D015427:Reperfusion Injury; D013524:Surgical Flaps / Q000098:blood supply*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
chemical_list: D018696:Neuroprotective Agents; D042461:Vascular Endothelial Growth Factor A; D010889:Piracetam