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Halim AS, Wan Ahmad Kamal WS, Noor NM, et al. Effects of ischemic preconditioning of different intraoperative ischemic times of vascularized bone graft rabbit models. Arch Plast Surg. 2013;40(6):687-96doi: 10.5999/aps.2013.40.6.687.
Halim, A. S., Wan Ahmad Kamal, W. S., Noor, N. M., & Abdullah, S. (2013). Effects of ischemic preconditioning of different intraoperative ischemic times of vascularized bone graft rabbit models. Archives of plastic surgery, 40(6), 687-96. https://doi.org/10.5999/aps.2013.40.6.687
Halim, Ahmad Sukari, et al. "Effects of ischemic preconditioning of different intraoperative ischemic times of vascularized bone graft rabbit models." Archives of plastic surgery vol. 40,6 (2013): 687-96. doi: https://doi.org/10.5999/aps.2013.40.6.687
Halim AS, Wan Ahmad Kamal WS, Noor NM, Abdullah S. Effects of ischemic preconditioning of different intraoperative ischemic times of vascularized bone graft rabbit models. Arch Plast Surg. 2013 Nov;40(6):687-96. doi: 10.5999/aps.2013.40.6.687. Epub 2013 Nov 08. PMID: 24286040; PMCID: PMC3840174.
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Arch Plast Surg. 2013 Nov;40(6):687-96. doi: 10.5999/aps.2013.40.6.687. Epub 2013 Nov 08.

Effects of ischemic preconditioning of different intraoperative ischemic times of vascularized bone graft rabbit models.

Archives of plastic surgery

Ahmad Sukari Halim, Wan Syazli Rodzaia Wan Ahmad Kamal, Norizal Mohd Noor, Shafie Abdullah

Affiliations

  1. Reconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

PMID: 24286040 PMCID: PMC3840174 DOI: 10.5999/aps.2013.40.6.687

Abstract

BACKGROUND: Ischemic preconditioning has been shown to improve the outcomes of hypoxic tolerance of the heart, brain, lung, liver, jejunum, skin, and muscle tissues. However, to date, no report of ischemic preconditioning on vascularized bone grafts has been published.

METHODS: Sixteen rabbits were divided into four groups with ischemic times of 2, 6, 14, and 18 hours. Half of the rabbits in each group underwent ischemic preconditioning. The osteomyocutaneous flaps consisted of the tibia bone, from which the overlying muscle and skin were raised. The technique of ischemic preconditioning involved applying a vascular clamp to the pedicle for 3 cycles of 10 minutes each. The rabbits then underwent serial plain radiography and computed tomography imaging on the first, second, fourth, and sixth postoperative weeks. Following this, all of the rabbits were sacrificed and histological examinations were performed.

RESULTS: The results showed that for clinical analysis of the skin flaps and bone grafts, the preconditioned groups showed better survivability. In the plain radiographs, except for two non-preconditioned rabbits with intraoperative ischemic times of 6 hours, all began to show early callus formation at the fourth week. The computed tomography findings showed more callus formation in the preconditioned groups for all of the ischemic times except for the 18-hour group. The histological findings correlated with the radiological findings. There was no statistical significance in the difference between the two groups.

CONCLUSIONS: In conclusion, ischemic preconditioning improved the survivability of skin flaps and increased callus formation during the healing process of vascularized bone grafts.

Keywords: Free tissue flaps; Ischemic preconditioning; Microsurgery

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