Pharmacological Preconditioning in Free Tissue Transfer: The Role of Heme Oxygenase-1

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Head and neck cancer is a devastating disease. Its incidence continues to increase in the UK. Surgical removal of the cancer is the cornerstone of treatment, but often requires reconstruction of tissues, such as the tongue and lip, to restore function and minimise the psychological effects of surgery. Reconstruction is achieved by transferring tissue from elsewhere in the body, such as skin from the forearm, a procedure is known as free tissue transfer (FTT). However, FTT has a significant failure rate. This is due to damage during the operation, a direct result of the blood supply being interrupted whilst the tissue is harvested, transferred and reconnected in the new site. Pretreatment or ‘preconditioning‘ of tissues could reduce the severity of this injury and improve the success rates of free tissue transfer in patients undergoing reconstructive surgery.This study will assess the ability of specific agents to precondition tissue which could be used for free tissue transfer. It will use an animal model of FTT to determine whether preconditioning does reduce injury in these tissues. The study agents are suitable for human use. If successful, this work will form a sound basis for translating preconditioning treatments into clinical studies.