ABSTRACT
Fructose 1, 6 diphosphate (FDP), a metabolic intermediate, provides an alternative
mechanism to circumvent the rate-limiting step in the Kreb's cycle. This agent has
been observed to prevent the effects of ischemia on heart tissue and kidney function
and the effects of endotoxic shock. It has been shown conclusively to minimize the
adverse effects of ischemia-reperfusion injury in experimental pedicled skin flaps
in animals. The present study was done to evaluate the effect of intra-arterial administration
of FDP on salvage of ischemic microvascular transfer of gracilis muscle flaps in rats,
with the premise that it might prolong the ischemia time of muscle flaps at room temperature,
thus increasing chances of flap survival. Irrigation with FDP did not change the quantitative
survival of the flaps, but there was qualitative improvement on histologic evaluation
and DNA analysis. Decreased inflammatory damage and DNA fragmentation were seen at
the 2.5-hr period. Histologic staining for mitochondrial oxygenation in gracilis muscle
also showed increased uptake in the FDP-treated group vs. control at the 2.5-hr ischemia
period. Further experiments with different modes of FDP administration should be carried
out to identify more effective means of amelioration of flap ischemia.
KEYWORDS
Ischemia reperfusion injury - fructose diphosphate - microvascular transfer - gracilis
muscle flaps in rats
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Sheila G LindleyM.D.
Department of Orthopedic Surgery, University of Mississippi Medical Center
2500 N. State street, Jackson, MS 39216
