Investigation of hydrogen sulphide's protective effects against ischemia-reperfusion injury at rat skin flaps

Investigation of Hydrogen Sulphide's Protective Effects against Ischemia-Reperfusion Injury at Rat Skin Flaps Introduction and aim: Ischemia-reperfusion injury is a pathophysiologically complicated process that can occur in many circumstances like cancer, infection, surgical clamping or occlusive disorders. Researches that investigate the effects of hydrogen sulfide on ischemia-reperfusion injury are made on cerebral, renal, adipose tissue, intestinal and hepatic system and favourable effects are shown. Aim of this study is to investigate the effects of hydrogen sulfide by generating ischemia-reperfusion injury at the vascular pedicle island flap. That is elevated from the inguinal region of rat and express the effects by using tissue neutrophile counting, MDA (malondialdehyde) that is one of the lipid peroxidation product biochemically and apoptosis and cellular activities that is obtained by electron microscopy. By this means researching the probability of hydrogen sulfide's clinical application as medicine is aimed. Materials and methods: Wistar Albino rats weighting 250-300 gr are seperated into groupes as sham, ischemia, serum physiologic (SF) control and hydrogen sulfide. All of the rats are operated under xylazine and ketamine anesthesia. At the sham group 6x4 cm skin flap from the groin region is incised and elevating the flap and after elevation flep suturred at the their original places . At the other groups 6x4 cm superficial epigastric artery pedicled skin flaps from the groin region are elevated. At the ischemia group no additional intervention is made before ischemia. At the Sf control group 1mg/kg Sf is given via the tail vein 20 minutes before ischemia. At the hydrogen sulfide group 10μM liquid hydrogen sulfide is given via the tail vein 20 minutes before ischemia. Following the occlusion of blood flow at the femoral artery and vein with microclips, flaps are sutured at their original places. After 6 hours, flaps are reelevated, perfusions are ensured and flaps are resutured. After 12 hours specimens are taken. Neutrophile counting is done at the hemotoxylene eosine stained specimen, MDA (malondialdehyde) that is one of the lipid peroxidation products is biochemically measured and ischemia-reperfusion injury and apoptosis processes are evaluated at the cellular levels by electron microscope. Results: As a result of this study, protective effects of hydrogen sulfide againts ischemia reperfusion injury at cellular level were seen as electron microscopic, however due to the length of ischemia time (6 hours), tissue neutrophil counting and lipid peroxidation were found no effect on the end product. We believe that new studies with hydrogen sulfide may provide optimal conditions for different ischemia times, especially in free flap surgiries, and may provide a protective effect againts ischemia reperfusion injury. Conclusion: As a result of this study, hydrogen sulfide's protective effects, especially at the cellular levels, against ischemia-reperfusion injury are shown by electron microscopy but because of long ischemia time hydrogen sulfide has effect on neither tissue neutrophile counting nor lipid peroxidation products. Determinig the optimal conditions by designing new ischemia-reperfusion reseraches with hydrogen sulfide with different ischemia times will provide protective influences especially for free flap surgeries. Keywords: hydrogen sulphide, ischemia-reperfusion