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Cyclophosphamide-induced neutropenia: effect on postischemic skin-flap survival
C Lee1, C L Kerrigan, L A Picard-Ami
1Microsurgical Research Laboratory, Royal Victoria Hospital, Montreal, P.Q., Canada.
Plastic and Reconstructive Surgery
|June 11, 1992
Summary
Neutrophil depletion using cyclophosphamide did not affect cutaneous flap survival after ischemia. However, it significantly protected latissimus dorsi myocutaneous flaps, implicating neutrophils in ischemia/reperfusion injury.
Area of Science:
- Surgical Research
- Immunology
- Vascular Biology
Background:
- Ischemia/reperfusion (I/R) injury is a significant concern in flap surgery.
- Neutrophils are implicated in inflammatory processes and tissue damage following I/R.
Purpose of the Study:
- To investigate the role of neutrophils in I/R injury in different types of surgical flaps.
- To determine if neutropenia affects the survival of postischemic cutaneous and myocutaneous flaps.
Main Methods:
- A blinded study involving 24 pigs randomized to cyclophosphamide (to induce neutropenia) or placebo.
- Creation of buttock cutaneous and latissimus dorsi myocutaneous flaps.
- Subjecting flaps to 6 hours of global ischemia followed by 24 hours of reperfusion.
- Assessment of flap skin and muscle survival.
Main Results:
- Cyclophosphamide effectively induced neutropenia in the treatment group.
- Neutropenia had no significant effect on the survival of postischemic cutaneous flaps.
- Cyclophosphamide-induced neutropenia significantly improved the survival of postischemic latissimus dorsi myocutaneous flaps.
Conclusions:
- Neutrophils play a critical role in mediating I/R injury in myocutaneous flaps.
- The protective effect of neutropenia varies depending on flap type.
- Targeting neutrophils may offer a therapeutic strategy to mitigate I/R injury in specific reconstructive surgeries.