Protective Effect of Heparin Against Ischemia–Reperfusion Injury in Rat Free Skin Flaps
Keywords:
Ischemia–reperfusion injury, Skin flap, Heparin, Neutrophils, Oxidative stress, Apoptosis, Malondialdehyde, Superoxide dismutase.Abstract
Background: Ischemia–reperfusion (I/R) injury is a major cause of partial or total flap necrosis in reconstructive surgery. Neutrophil infiltration, oxidative stress, and apoptosis contribute to tissue damage, Heparin may reduce I/R-induced injury by improving microvascular perfusion and limiting.inflammation.
Objective: To evaluate the protective effect of heparin against I/R injury in rat epigastric skin flaps.
Methods: sixteen adult Wistar albino rats were randomly assigned into two groups control group and heparin group (n=8 each). The heparin group received a single intravenous bolus of heparin (150 U/kg) 15 minutes before reperfusion. Flap viability, neutrophil infiltration, lipid peroxidation (MDA), superoxide dismutase (SOD) activity, and caspase-3 activity were assessed 48 hours after reperfusion. Statistical analyses were performed using ANOVA and Tukey’s post hoc test.
Results: Heparin significantly improved flap survival (75–83%, mean 80%) compared to the saline control group (2–17%, mean 9%). Neutrophil infiltration was significantly reduced (distal mean 122.8/HPF; central mean 46.1/HPF). Heparin treatment decreased MDA levels, preserved SOD activity, and lowered caspase-3 activity compared to untreated I/R flaps (P<0.001).
Conclusion: Heparin confers substantial protection against I/R injury in rat skin flaps by reducing inflammation, oxidative stress, and apoptosis. These findings suggest its potential use as a prophylactic agent in flap surgeries.
