The impact of ischemic postconditioning on ischemic skin flap injuries

Ischemic postconditioning (IPOC) is a useful manipulation to reduce the undesirable effects of ischemia-reperfusion (IR) injury. The effects of IPOC were studied in an axial pattern skin flap model.

The skin flaps of 40 rabbits were randomly divided into four groups. Ischemic postconditioning was performed using six 10-second cycles of repeated ischemia/reperfusion periods. The animals were al- located into four groups: group 1 (control); group 2 (ischemia); group 3 (postconditioning); group 4 (postconditioning 10 minutes later). Flap viability was assessed 1 week after the operation. The surviving flap area was recorded as a percentage of the entire flap area. Fisher's least significant difference (LSD) test was used for statistical analysis among different groups to evaluate the effects of ischemic preconditioning against ischemia.

The mean ± SD of surviving flap areas for groups 1, 2, 3, and 4 were 97.86 ± 0.62, 31.64 ± 1.04, 48.95 ± 0.82, and 30.01 ± 1.12, respectively. Statistical difference did not exist between group 2 and 4, but they were statistically different (P < 0.05) when compared to group 1 or group 3.

Ischemic postconditioning has a protective effect on ischemic flaps, but post- conditioning should be performed just after the ischemic event. .