Experimental Study Of The Effect Of Reduced Glutathione On Random Flap Survival In Rats

In plastic and reconstructive surgery, random skin flap is one of the most widely used flaps in repairing wounds, reconstructing functions and improving outlooks. The necrosis of the distal part of the flap is a serious complication that commonly happen. Therefore the long-broad ratio of the flap is restricted to a certain extent, otherwise the flap may be necrosis, which can influence the application of flap' s use in the clinical practice.Some reseaches show that the ischemic/reperfusion tissue injury is a crucial cause for the flap necrosis, and a great mount of the oxygen free radical(OR) and lipidperoxidation(LPO) produced in that process plays an important role in the mechanism of the flap necrosis. So the administration of OR scavengers may increase the survival of skin flap.And glutathione(GSH) can reduce OR and LPO effectively.Object: To investigate the effects of GSH on survival of the ischemic random skin flap in rats. In addition, discuss some probable mechanism that contribute to this effect.Method: Twenty healthy SD rats, male 8 and femal 12, with 200 to 250 gram in weight, were randomly distributed to the experimental group and the control one. Random flap 2cm× 8cm inshape was made on the back of each rat with the pedicelon the angular of the scapular. GSH(250mg/kg) and NS of the same dose were injected into the abdominal cavity of rats in experimental group and the control one at once after the operation, lday and 2day respectively. The rats were killed 7th day after the operation. The comparison of two groups included the gross observation, tissue pathology, the survival ratio of the flap, the superoxide dismutase(SOD) and Malonyldialdehyde (MDA) level.Result: 1) The mean survival rate of the flap (SR=surviving area/total area of skin flap) at the 7th day in experimental group is higher than the control group, which shows significant difference (p<0.05) 2) Statistically significant difference was obtained in MDA level in experimental group compared to the control group (p<0. 05). 3) There is also significant difference in SOD level in rats in 2 groups. (p<0.05).Conclusion:The intraperitoneal use of GSH may promote the surviving of the rat ischemic random skin flaps and the possible mechanism for improvement may lies in that the GSH can reduce the level of OR and LPO.