The effect of postconditioning on the muscle flap survival after ischemia-reperfusion injury in rats.

ABSTRACTBackground: Timely recognition of vascular compromise of free flaps is crucial to salvaging failing flaps due to the vulnerability of muscle tissues to ischemia. The concept of postconditioning (post-con) that has been introduced as an “after injury” strategy may be beneficial to salvage the failing muscle flaps. We aim to investigate the effect of post-con on the muscle flap survival after ischemia-reperfusion (I/R) injury in rats. Materials and methods: The gracilis muscle flap model was used and a complete 4 hr of ischemia was generated by occlusion of the pedicle of dissected flap. The post-con procedure was started at the end of ischemia with six cycles of 15 s of reperfusion, followed by 15 s of complete reocclusion prior to the unlimited reperfusion. Muscle edema, malondialdehyde (MDA) level, muscle viability, and different time intervals (0, 3, 6, 18 hr) of gene expression of VEGF post-perfusion were assessed. Results: Significant difference in muscle viability was noted between the post-c...