The role of platelet-activating factor in musculocutaneous flap reperfusion injury

Plastic and Reconstructive Surgery
M A Stotland, C L Kerrigan

Abstract

Platelet-activating factor is an extremely potent lipid-inflammatory mediator implicated in the pathophysiologic mechanism of reperfusion injury in a variety of organs. The purpose of this study, employing a porcine latissimus dorsi flap model, was to (1) examine the expression of platelet-activating factor and (2) evaluate the possible benefit and mechanism of action of platelet-activating factor antagonism in musculocutaneous flap reperfusion injury. Experiment 1: In 6 pigs, bilateral flaps underwent 8 hours of arterial ischemia followed by 12 hours of reperfusion. Biopsies were collected sequentially and analyzed immunohistochemically for platelet-activating factor expression. Different processing techniques, however, were unable to detect specific tissue expression of platelet-activating factor. Experiment 2: In 11 pigs, bilateral flaps underwent 8 hours of arterial ischemia followed by 20 hours of reperfusion. A lipophilic platelet-activating factor receptor antagonist (L-659,989) was administered as a single dose to treated flaps by a local intraarterial route prior to reperfusion. This treatment augmented the survival of both muscle (48.3 versus 19.7 percent) and skin (49.8 versus 42.0 percent) components of the flaps in...Continue Reading

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