Ethyl pyruvate improves skin flap survival after ischaemia reperfusion injury

Indian J Med Res. 2017 Sep;146(3):369-374. doi: 10.4103/ijmr.IJMR_1428_14.

Abstract

Background & objectives: Reperfusion after ischaemia is detrimental to the tissues. The oxidative stress created and cytokines released are mostly responsible in this process. In this study, ethyl pyruvate, a known agent for its anti-inflammatory and antioxidant properties, was used to investigate the effects on ischaemia/reperfusion injury on skin island flaps in rats.

Methods: Sixty rats were randomly distributed in three groups (non-ischaemic, ischaemic and medication groups). Ethyl pyruvate was administered in the medication group with a dose of 50 mg/kg. After 24 h and one week, the animals were sacrificed, and the flaps were analyzed macroscopically, histopathologically, biochemically (total nitrite, malondialdehyde and myeloperoxidase).

Results: Biochemical markers indicating oxidative stress, were found elevated in ischaemic group, whereas medication with ethyl pyruvate significantly reduced these values. There was a significant reduction (P<0.05) in the levels of these markers between ischaemic and medication groups. Ethyl pyruvate improved all the parameters significantly.

Interpretation & conclusion: Ethyl pyruvate showed strong scavenger activity against reactive oxygen species. It could be a potential candidate to improve the flap viability in reconstructive microsurgery, especially in free tissue transfers. However, more studies are warranted in experimental models to confirm these findings.

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / administration & dosage*
  • Antioxidants / administration & dosage
  • Humans
  • Malondialdehyde / metabolism
  • Oxidative Stress / drug effects*
  • Peroxidase / metabolism
  • Pyruvates / administration & dosage*
  • Rats
  • Reperfusion Injury / drug therapy*
  • Reperfusion Injury / pathology
  • Reperfusion Injury / surgery
  • Skin / drug effects
  • Skin / pathology
  • Surgical Flaps / adverse effects

Substances

  • Anti-Inflammatory Agents
  • Antioxidants
  • Pyruvates
  • ethyl pyruvate
  • Malondialdehyde
  • Peroxidase