Evaluating the efficiency of Resveratrol on ischemia reperfusion injury in skin flaps

Although flaps have been described centuries ago, there are many questions waiting for answers about basic physiology of the flaps. Though increase of the knowledge with studies about anatomy, physiology and surgical technical areas, flap necrosis is still an important problem. One of the important cause of flap loss is I/R injury.Resveratrol which is found ample in grapes is a polyphenol and a natural antioxidant. In experimental studies resveratrol was found that it was effective on preventing I/R injury in several tissues like liver and brain.Efficiency of resveratrol on preventing I/R injury in several tissues directed us to research whether this antioxidant has an effect on I/R injury in skin flaps or not.In experimental study with this purpose 21 rats were used. Rats were divided into 3 groups. In sham group inferior epigastric artery flaps were elevated and I/R wasn?t applied. In I/R group ischemia was applied for 8 hours followed by reperfusion. In I/R+res group 5mg/kg resveratrol was administered 15 minutes before ischemia and just before the onset of reperfusion. After 24 hours from reperfusion and 7th postoperative day specimens were taken from all groups for histological examination. Early and late periods specimens were stained with haematoxylin and eosin to identify tissue morphology. Distributions of IL-1ß and TNF-? were investigated in early specimens. Distributions of VEGF, Flk-1, Flt-1 and rate of apoptotic cells were investigated in late specimens. All flaps were photographed on 7th postoperative day and rates of surviving flaps were calculated.It was found that resveratrol increased rates of surviving flaps significantly. On the other hand resveratrol wasn?t effective on supressing inflammatory cytokines and on inducing VEGF, Flt-1, it only induced Flk-1 minimally. Also, it was found that apoptosis didn?t play an effective role on I/R injury in skin flaps.As a result of this study we think that resveratrol is effective on preventing I/R injury in skin flaps and it is promising for clinical usage.