Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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The Effect of Erythropoietin on Ischemia-Reperfusion Injury: An Experimental Study in Rat TRAM Flap Model

백서 복직근판의 허혈-재관류 손상에 대한 Erythropoietin의 영향

  • Kim, Eun Key (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hong, Joon Pio (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 김은기 (울산대학교 의과대학 서울아산병원 성형외과학교실) ;
  • 홍준표 (울산대학교 의과대학 서울아산병원 성형외과학교실)
  • Received : 2006.04.03
  • Published : 2006.09.10
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Abstract

Purpose: Erythropoietin is traditionally known to regulate erythropoiesis, but recently its protective effect against ischemia-reperfusion injury has been studied mainly in cardiovascular and neuronal systems. This study was planned to investigate the effects of recombinant human erythropoietin on ischemia-reperfusion injury in rat TRAM flap model. Methods: Superiorly based TRAM flap was elevated and ischemic insult was given for four hours. Thirty minutes before reperfusion, single dose recombinant human Erythropoietin(5000IU/kg) was injected via intraperitoneal route in the treatment group. At 24 hours postoperatively, systemic neutrophil count, tissue myeloperoxidase activity, malonyldialdehyde amount, nitric oxide content, tissue water content and histologic finding of inflammation was evaluated. On 10 days postoperatively, flap survival rate, angiogenesis and change in hematocrit level was evaluated. Results: Tissue nitric oxide level was significantly higher and myeloperoxidase activity was significantly lower in the treatment group 24 hours after reperfusion. Tissue water content was significantly lower in the treatment group. Perivascular neutrophil infiltration and intravascular adhesion was marked in the control group. Mean flap survival after ten days was 69% in the treatment group, and 47% in the control group, demonstrating a significant difference. Neovascularization in the treatment group also outnumbered the control group. No significant hematocrit rise was noted ten days after erythropoietin administration. Conclusion: Recombinant human Erythropoietin improved flap survival in ischemia-reperfusion injured rat TRAM flaps, at least partially owing to suppressed inflammation, increased nitric oxide, and enhanced angiogenesis.

Keywords

References

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