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Bilirubin provides perforator flap protection from ischaemia-reperfusion injury in a rat model; a preliminary result

Authors
 Sung Young Kim ; Dong Kyun Rah ; Tae Hwan Park ; Song Hyun Lee ; Yosep Chong 
Citation
 International Wound Journal , Vol.13(5) : 870~877, 2015 
Journal Title
 International Wound Journal 
ISSN
 1742-4801 
Issue Date
2015
Abstract
The use of bilirubin, a well-known and powerful antioxidant, has gained popularity in recent years because of its role in the prevention of ischaemic heart disease in patients with Gilbert's syndrome. We investigate the effects of bilirubin on ischaemia-reperfusion (I/R) injury using a rat perforator flap model. Forty-eight rats were randomly divided into two groups: experimental (bilirubin) group (n = 24) and control group (n = 24). In each group, elevated bilateral deep inferior epigastric perforator (DIEP) flaps were created. The right (no ischaemia side) and left (ischaemia side) DIEP flaps were separated according to the presence of ischaemia induction. Ischaemia was induced in anaesthetised rats by perforator clamping for 15 or 30 minutes. After surgery, the flap survival was assessed daily on postoperative days 0 to 5, and overall histological changes of DIEP flaps above the perforator were analysed at postoperative day 5. The flap survival rate in the bilirubin group was significantly higher than that in the control group at the ischaemia side following perforator clamping for 15 or 30 minutes (93·42 ± 4·48% versus 89·63 ± 3·98%, P = 0·002; and 83·96 ± 4·23% versus 36·46 ± 6·38%, P < 0·001, respectively). The difference in flap survival between the two groups was the most prominent on the ischaemic side following 30 minutes of perforator clamping. From a morphologic perspective, pre-treatment with bilirubin was found to alleviate perforator flap necrosis caused by I/R injury in this experimental rat model.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/141819
DOI
10.1111/iwj.12396
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Plastic Surgery & Reconstructive Surgery
Yonsei Authors
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Link
 http://onlinelibrary.wiley.com/doi/10.1111/iwj.12396/abstract
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