Summary
Background
A better understanding of the pathophysiology of ischaemia-reperfusion injury and
a possible treatment for it, is of great importance. The deep inferior epigastric
perforator (DIEP) flap is an innovative, clinical model of ischaemia-reperfusion.
There has been an ongoing interest in the health benefits and medical applications
of antioxidants. We hypothesised that during ischaemia-reperfusion, specific antioxidants
are depleted.
Methods
Seventeen DIEP flaps were performed in 15 patients undergoing breast reconstruction.
In each free flap, 3-mm skin biopsies were taken from the DIEP flap at four different
time points during and after surgery. In those tissue biopsies, concentrations of
the antioxidants vitamin E, glutathione (GSH) and uric acid and total antioxidant
capacity (TEAC) were measured.
Results
Unexpectedly, no immediate change was observed in GSH concentrations during ischaemia-reperfusion.
Uric acid concentrations were significantly increased at all time points following
reperfusion. Vitamin E concentrations also showed a significant incline 30 min and 1 h after reperfusion. However, 1 h after reperfusion, a significant decrease in total hydrophilic antioxidant capacity
(TEAC) was seen. In the next hour, this capacity recovered.
Conclusions
During ischaemia-reperfusion, a deficiency in hydrophilic antioxidant capacity develops.
This is a potential cause for the development of ischaemia-reperfusion injury by reactive
oxygen species.
This clinical trial is registered on Clinical Trials: http://www.clinicaltrials.gov/.
Trial registry name: The DIEP-flap as a model of ischaemia-reperfusion.
Registration identification number (NCT): 00482469.
Keywords
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Article info
Publication history
Published online: July 12, 2012
Accepted:
June 11,
2012
Received:
June 16,
2010
Footnotes
☆This paper was presented at the Spring Congress of the Dutch Society of Plastic Surgery of 30 May–1 June, 2008.
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
