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CC BY-NC 4.0 · Arch Plast Surg 2013; 40(06): 687-696
DOI: 10.5999/aps.2013.40.6.687
Original Article

Effects of Ischemic Preconditioning of Different Intraoperative Ischemic Times of Vascularized Bone Graft Rabbit Models

Ahmad Sukari Halim
Reconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
,
Wan Syazli Rodzaia Wan Ahmad Kamal
Reconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
Faculty of Medicine, MARA Institute of Technology University (UiTM), Sungai Buloh, Selangor, Malaysia
,
Norizal Mohd Noor
Faculty of Medicine, MARA Institute of Technology University (UiTM), Sungai Buloh, Selangor, Malaysia
,
Shafie Abdullah
Reconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Background Ischemic preconditioning has been shown to improve the outcomes of hypoxic tolerance of the heart, brain, lung, liver, jejunum, skin, and muscle tissues. However, to date, no report of ischemic preconditioning on vascularized bone grafts has been published.

Methods Sixteen rabbits were divided into four groups with ischemic times of 2, 6, 14, and 18 hours. Half of the rabbits in each group underwent ischemic preconditioning. The osteomyocutaneous flaps consisted of the tibia bone, from which the overlying muscle and skin were raised. The technique of ischemic preconditioning involved applying a vascular clamp to the pedicle for 3 cycles of 10 minutes each. The rabbits then underwent serial plain radiography and computed tomography imaging on the first, second, fourth, and sixth postoperative weeks. Following this, all of the rabbits were sacrificed and histological examinations were performed.

Results The results showed that for clinical analysis of the skin flaps and bone grafts, the preconditioned groups showed better survivability. In the plain radiographs, except for two non-preconditioned rabbits with intraoperative ischemic times of 6 hours, all began to show early callus formation at the fourth week. The computed tomography findings showed more callus formation in the preconditioned groups for all of the ischemic times except for the 18-hour group. The histological findings correlated with the radiological findings. There was no statistical significance in the difference between the two groups.

Conclusions In conclusion, ischemic preconditioning improved the survivability of skin flaps and increased callus formation during the healing process of vascularized bone grafts.

Keywords

Free tissue flaps - Ischemic preconditioning - Microsurgery

This study was supported by Universiti Sains Malaysia short-term grant (No USM/PPSP®/2010/JKP-43[43.3(B)]).


This paper was presented during the Annual Scientific Meeting of the Royal Australasian College of Surgeons, Kuala Lumpur held in May 6-10, of which the abstract has been published in the supplementary issue of the (ANZ) Journal of Surgery, Volume 82 (Supplement 1) page 138.




Publication History

Received: 03 June 2013

Accepted: 07 August 2013

Article published online:
01 May 2022

© 2013. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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