Oxidative processes and free radical scavengers in ischaemia-reperfusion injury in adipocutaneous flaps: In vitro lipid peroxidation assessment

An in vitro lipid peroxidation study measuring Schiff base and TBAR formation in homogenates of the fat and skin fractions of epigastric free flaps of DA-rats was performed to determine the role of oxygen-derived free radicals (ODFRs) in the aetiology of ischaemic injury and of ischaemia and reperfusion injury following cold (0-1 degree C) storage. The storage intervals were 0, 48, 72, 96 and 120 h in the study on ischaemic injury and 72 and 96 h in the study on combined ischaemia and reperfusion injury. Reperfusion was accomplished by anastomosing the pedicle vessels of the flap to the femoral vessels of a recipient; the reperfusion period was 15 min. In addition to a control group (C), three experimental groups were created to test the benefit of a preischaemic single passage perfusion with a hypertonic citrate solution (HCA), a pre- and postischaemic treatment with desferrioxamine (DFX) and a pre- and postischaemic treatment with lipoic acid (LA). 

The susceptibility of homogenates of skin and fat fractions of epigastric free flaps in DA-rats for lipid peroxidation increased significantly whenever the cold (0-1 degree C) ischaemic interval was prolonged from 0 to 72 h. These findings offer circumstantial evidence for the role of ODFRs in the aetiology of ischaemic injury. 

Following a short reperfusion period after extended periods of cold (0-1 degree C) ischaemia, no significant increase in susceptibility for lipid peroxidation could be found. Furthermore, no unequivocal role in the prevention of ischaemia and/or reperfusion injury by the use of either HCA, or DFX or LA could be found. The exact role of ODFRs in the aetiology of ischaemia-reperfusion injury in this setting remains unclear.