Comparison of the effects of different vasoactive and antiplatelet drugs on perforator flap viability. An experimental study

Demir, Bülent; Engin, Murat Sinan; Keleş, Musa Kemal; Küçüker, İsmail; Yosma, Engin

doi:10.1016/j.hansur.2015.08.001

Cited by 10 publications

(7 citation statements)

References 18 publications

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“…In their study, Demir et al also found that piracetam was associated with increased perforator flap viability while it did not cause a rise in the vascular density. 59 Although this study was not investigating reperfusion injury, their results support our idea that the positive effect of piracetam exerts over its benefits on microcirculation.…”

Section: Discussionsupporting

confidence: 72%

Comparison of Ischemic Preconditioning and Systemic Piracetam for Prevention of Ischemia-Reperfusion Injury in Musculocutaneous Flaps

Demiröz

Derebaşınlıoğlu

Ercan

et al. 2020

J Reconstr Microsurg

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Background Ischemia-reperfusion injury plays an important role in flap failure. Ischemic preconditioning technique is the only proven method for preventing ischemia-reperfusion injury, but it is not used widely in daily practice because of difficulties such as prolonging the operation time, need for surgical experience, and increasing the risk of complications. This study has been performed with the assumption that piracetam may be a simple and inexpensive alternative to the preconditioning technique due to its antioxidant, antiaggregant, rheological, anti-inflammatory, antiapoptotic, cytoprotective, and immune modulating effects. Methods Thirty-two rats were divided into four groups and latissimus dorsi musculocutaneous flaps were raised. No extra procedure was applied, and no treatment was given to the control group. Four hours of ischemia was created by clamping the thoracodorsal pedicle in the second group. The animals in the third group were treated with 10 minutes of ischemia and reperfusion periods as a preconditioning procedure before the 4 hours of ischemia. Animals in the fourth group received systemic piracetam 30 minutes before and 6 days after reperfusion. Nitric oxide and myeloperoxidase levels in serum and tissue, acute inflammatory cell response, and vascular proliferation in tissue were examined at the postoperative 24th hour and 10th day. Results Myeloperoxidase activity in both preconditioning and piracetam groups, was significantly lower than the ischemia-reperfusion group. Acute inflammatory cell response was similarly decreased in both preconditioning and piracetam groups compared with ischemia-reperfusion group. Tissue measurements of nitric oxide were also significantly higher in both preconditioning and piracetam groups than in the ischemia-reperfusion group. However, vascular proliferation increased in the preconditioning group, while it did not show any significant change in the piracetam group. Conclusion This study shows that systemic piracetam treatment provides protection against ischemia-reperfusion injury in musculocutaneous flaps and can offer a simple and inexpensive alternative to the preconditioning technique.

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Section: Discussionsupporting

confidence: 72%

Comparison of Ischemic Preconditioning and Systemic Piracetam for Prevention of Ischemia-Reperfusion Injury in Musculocutaneous Flaps

Demiröz

Derebaşınlıoğlu

Ercan

et al. 2020

J Reconstr Microsurg

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“…Numerous prior studies have examined the efficacy of perioperative use of antithrombotic and/or antiplatelet agents in free flap surgery (Ashjian et al, 2007;Conrad & Adams Jr., 2001;Demir et al, 2016;Grill et al, 2023;Senchenkov et al, 2015). One major challenge in these studies has been the presence of selection bias, as the decision to use such medications or not could be often influenced by factors related to the surgeon or other variables, which could act as potentially significant confounders.…”

Section: Discussionmentioning

confidence: 99%

Clinical effectiveness of postoperative prostaglandin E1 administration in reducing flap necrosis following microsurgical reconstruction

Park,

Lee

2024

Microsurgery

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BackgroundExtensive experimental evidence has suggested the potential efficacy of prostaglandin E1 (PGE1) in enhancing flap survival, leading to its widespread empirical use following free flap operation. However, the translation of these experimental findings into clinical benefits remains uncertain. This study aimed to assess the clinical effectiveness of postoperative PGE1 administration on the outcomes of microsurgical reconstruction.MethodsA retrospective review was conducted for patients who underwent free flap‐based reconstruction between September 2020 and November 2022, dividing into two cohorts. For all consecutive cases conducted during the formal half, PGE1 was administered for postoperative 7 days (PGE1 cohort), and for those during the latter, PGE1 was not given (non‐PGE1 cohort). The profiles of perfusion‐related complications (PRC) were compared between the two cohorts. Further analyses after propensity‐score matching were performed.ResultsIn total, 274 cases were analyzed, consisting of 142 in PGE1 and 132 in non‐PGE1 cohort. Baseline characteristics were similar between the two cohorts, except for higher rates of comorbidities and chronic wound‐related defects in the PGE1 cohort. Overall PRC developed in 37 cases (13.5%), including 6 (2.1%) total loss and 38 (10.2%) partial necrosis. Compared to the control, the PGE1 cohort exhibited significantly lower rates of overall PRC and partial flap necrosis. This difference remained significant on multivariable analyses. The rate of total flap loss did not differ between the cohorts. Consistent associations were observed in the propensity‐score matching analysis.ConclusionPostoperative administration of PGE1 appears to be associated with reduced risks for the development of partial flap necrosis.

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“…Se produce una activación de los canales de potasio realizándose la salida de estos hacia la membrana celular del musculo liso y originando hiperpolarización que por un mecanismo no bioquímico actúa sobre los canales de calcio provocando en ellos su cierre lo que conduce a una disminución de estos impidiendo que se forme el complejo calcio-calmodulina, la cual se uniría a la cinasa de cadenas ligeras de miosina, que pone grupos fosfatos en la cadena de miosina, el cual se obtiene del ATP convirtiéndose en ADP (Demir et al, 2016). Esa cabeza de miosina se uniría a la actina tironeándola y originando la contracción.…”

Section: Papel De Los Canales De Potasiounclassified

Trastornos hipertensivos durante el embarazo

Paneque¹,

Fernández²,

Quiñones³

et al. 2022

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La obra aborda aspectos importantes como: factores de riesgos, clasificación, algunas condiciones intrínsecas y extrínsecas vinculadas a esta patología, su etiopatogenia y fisiopatología, complicaciones maternas y perinatales; así como sus protocolos de atención, destacándose: el control de la hipertensión arterial, prevención de la convulsión eclámptica, vigilancia biológica y optimización de la extracción; con el propósito de estabilizar a la gestante en espera de la interrupción del embarazo como tratamiento definitivo que será dependiente de la edad gestacional y las condiciones clínicas materno fetales.

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Comparison of the effects of different vasoactive and antiplatelet drugs on perforator flap viability. An experimental study

Cited by 10 publications

References 18 publications

Comparison of Ischemic Preconditioning and Systemic Piracetam for Prevention of Ischemia-Reperfusion Injury in Musculocutaneous Flaps

Comparison of Ischemic Preconditioning and Systemic Piracetam for Prevention of Ischemia-Reperfusion Injury in Musculocutaneous Flaps

Clinical effectiveness of postoperative prostaglandin E1 administration in reducing flap necrosis following microsurgical reconstruction

Trastornos hipertensivos durante el embarazo

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