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Clin Hemorheol Microcirc. 2015;59(4):335-43. doi: 10.3233/CH-131803.

Protective effects of activated protein C (APC) on free groin flaps after secondary venous stasis in the rat model.

Author information

1
Hand Surgery, Plastic Surgery and Aesthetic Surgery, University Hospital of the Ludwig-Maximilians-University, Munich, Germany.
2
Consultant for Lymphology of the Surgical Clinic Munich Bogenhausen, Munich, Germany.

Abstract

BACKGROUND:

The goal of this study was to determine whether the focused delivery of APC by rinsing of free adipocutaneous groin flaps shows protective effects on flap survival following a fatal secondary venous stasis in a rat model.

METHODS:

36 Sprague Dawley rats were randomized to three groups and free microvascular groin flaps were transplanted to the neck in each animal. 20 hours postoperatively the flap pedicle was re-explored and the distal stump of the flap artery was catheterised. Animals in group I (n = 12) remained untreated, whereas animals of group II were treated with 1 ml of Ringer's solution. Those in group III received 1 ml of APC (2 mg/kg). Afterwards the flap vein was clamped for 35 minutes. The skin of the flaps and the native contralateral groin was examined by intravital video microscopy using FITC-Dextran and CFDA-SE-labelled thrombocytes.

RESULTS:

APC-pretreatment significantly increased the functional capillary density (FCD) of the flaps. Flap viability was 8% in group I (n = 1/12), 9% in group II (n = 1/11) and 60% in group III (n = 6/10), respectively. No partial flap loss was detected.

CONCLUSIONS:

The focused delivery of APC resulted in significantly improved flap salvage.

KEYWORDS:

APC; Activated protein C; I/R; IVM; free flap; groin flap; intravital microscopy; ischemia; microsurgery; rat model; reperfusion

PMID:
24254581
DOI:
10.3233/CH-131803
[Indexed for MEDLINE]

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