Effects of Ischemic Preconditioning at Different Time Points on Ischemia-Reperfusion Injury in Free Flaps
Objective To observe the effects of ischemic preconditioning(IPC)at different time points on ischemia-reperfusion injury in free flaps.Methods Ninety patients with limb injuries treated at the 988th Hospital of Joint Logistics Support Force of PLA from December 2022 to July 2023 were selected.Under general anesthesia,elective anterolateral thigh free flap transplantation was performed.Patients were randomly divided into three groups using a random number table:Group A(IPC 1 hour before surgery),Group B(IPC 24 hours before surgery),and Group C(no IPC before surgery),with 30 cases in each group.IPC involved three cycles of brief ischemia/reperfusion.Venous blood samples were collected at 24 hours before surgery(T0),at the start of surgery(T1),1 hour after surgery(T2),12 hours after surgery(T3),and 24 hours after surgery(T4)to measure oxidative stress indicators[malondialdehyde(MDA),inducible nitric oxide synthase(iNOS)]and inflammatory factors[tumor necrosis factor-α(TNF-α)and P-selectin].The incidence and inactivation rates of vascular crises in the flaps within 7 days after surgery were recorded.Results There were no statistically significant differences in the incidence and inactivation rates of vascular crises in the flaps among the three groups within 7 days after surgery(P＞0.05).The levels of MDA,iNOS,TNF-α,and P-selectin were significantly different among the three groups(P＜0.05).The four biochemical indicators at different time points were significantly different(P＜0.05).There was a significant interaction between different groups and different time points(P＜0.05).Within-group comparisons:Compared with T0,the levels of the four biochemical indicators in each group increased at T2～T4,with statistically significant differences(P＜0.05).Compared with T2,the levels of the four biochemical indicators in each group decreased at T3～T4,with statistically significant differences(P＜0.05).Between-group comparisons:At T2 and T3,the levels of the four biochemical indicators in Groups A and B were significantly different from those in Group C(P＜0.05).At T2,T3,the levels of the four biochemical indicators in Group A were significantly different from those in Group B(P＜0.05).Conclusion Ischemic preconditioning at different time points can inhibit the expression of oxidative stress and inflammatory factors,providing a protective effect on free flaps.
different time pointsischemic preconditioningischemia-reperfusion injuryfree flaps
万方数据
维普
