Ischemia and reperfusion in skin flaps: effects of mannitol and vitamin C in reducing necrosis area in a rat experimental model

The aim of the present study was to develop an experimental model of ischemia-reperfusion injury in rat skin flap and to verify the effect of mannitol and vitamin C on reducing necrosis area. A 6- x 3-cm groin skin flap was raised and submitted to 8 hours of ischemia by clamping the vascular pedicle and to 7 days of reperfusion. The animals were divided in four groups: S1 and S2 (10 animals each) and C and T (14 animals each). In groups S1 and S2 skin flaps were not submitted to ischemia and animals received lactated Ringer's solution (S1) and antioxidant solution (S2). In groups C and T, flaps were subjected to 8 hours of warm ischemia and animals received Lactated Ringer's solution (Group C) and antioxidant solution immediately before reperfusion, (Group T). Flap survival was evaluated on the seventh day using a paper template technique and computer-assistant imaging analysis of necrotic and normal areas. Statistical analysis showed no area differences between groups C and T. The experimental model provided consistent necrotic area in control groups and drugs used were not effective in improving skin flap survival.