title: Comparing various surgical delay methods with ischemic preconditioning in the rat TRAM flap model.
abstract: Both surgical delay and ischemic preconditioning (IP) have been shown to be effective in improving the survival of flaps. We used a variety of flap delay methods and IP to increase the surviving area of the transverse rectus abdominis musculocutaneous (TRAM) flap in rats, and the results are compared in between. A 6-× 3-cm-sized TRAM flap in 40 Wistar rats was allocated into five groups. Group 1: TRAM flap was elevated from nondominant pedicle, and the flap was sutured to the original bed. Group 2: Left superior deep epigastric vessels (SDEV) were cut; 1 week later, TRAM flap was elevated. Group 3: Only skin incision was done; 1 week later, TRAM flap was elevated. Group 4: Skin incision was done, and the left SDEV were cut; 1 week later, TRAM flap was elevated. Group 5: TRAM flap was elevated; IP was performed using three cycles of 10 minutes of repeated ischemia/reperfusion (I/R) periods, and the flap was sutured to the original bed. The surviving area of the flap was statistically significant between the control and groups 2, 4, and 5 (p < 0.001), and groups 4 and 2 were superior to group 5. Although preconditioning has been intensively studied for the last two decades and partly provided its beneficial effects in I/R injury, we determined the IP increased the surviving area of the TRAM flap but not effective as much as surgical delay method.
authors.affiliation: Department of Plastic Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Ani
authors.initials: A
authors.lastname: Cinpolat
authors.affiliation: Department of Plastic Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Gamze
authors.initials: G
authors.lastname: Bektas
authors.affiliation: Department of Anesthesiology, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Nesil
authors.initials: N
authors.lastname: Coskunfirat
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Zumreta
authors.initials: Z
authors.lastname: Rizvanovic
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: O Koray
authors.initials: OK
authors.lastname: Coskunfirat
mesh_terms: D000818:Animals; D006085:Graft Survival; D019194:Ischemic Preconditioning; D051381:Rats; D017208:Rats, Wistar; D015427:Reperfusion Injury / Q000473:pathology*; D012867:Skin / Q000473:pathology*; D013524:Surgical Flaps / Q000098:blood supply* / Q000473:pathology; D013997:Time Factors