Involvement of reactive oxygen species in flap necrosis and development of its prevention by antioxidants.

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1)In attempts to substantiate the possible participation of reactive oxygen species, and significance of the xanthine oxidase system in both post-ischemic reperfusion necrosis of the island flap and distal necrosis of the pedicle flap, and to develop new pharmacological measures for salvaging flap necrosis, a series of experiments were made using an island flap model and a random-pattern flap model in rats. The results demonstrated a possible involvement of ROS in both post-ischemic necrosis of island flaps and distal necrosis of random flaps. Xanthine oxidase was significant in producing ROS only in the former.2)In order to examine the effect of topical use of SOD ointment which contains 1% SOD on the enhancement of flap survival, three experiments were made. Its application to the under surface of the flap or occlusive dressing was effective.3)Involvement of lipid peroxidation in flap necrosis and effect of topical application of herbal antioxidant in salvagng flap necrosis were investigated. Among the herbal antioxidants, ellagic acid exerted the strongest effect in suppressing lipid peroxide levels and increasing flap survival.4)Ischemic-reperfusion injury of island fat flap of rats was also investigated.