The role of the xanthine oxidase enszymatic system and allopurinol in the ischemia reperfusion injury of experimental skin and myocutaneous flaps /

Complications resulting in flap failure and tissue necrosis constitute a serious and frequent problem to the plastic surgeon. Oxygen derived free radicals have been implicated in a variety of pathological processes including the ischemia reperfusion injury (IRI) occurring in skin flaps. Previous work with experimental rat skin flaps has suggested that the xanthine oxidase (XO) enzymatic system may be the major source for these toxic radicals. Before the clinician and the patient can benefit from these experimental findings an animal model which closer resembles the clinical setting needs to be tested. In the laboratory I examined the role of XO and its potent inhibitor allopurinol in the IRI of skin and myocutaneous flaps. I have found negligible levels of XO enzyme in pig and human skin when compared to the rat. I have also found that no beneficial effect on survival could be observed by treating the flaps with several different dose regimens of allopurinol. Based on my results I conclude that it is unlikely that xanthine oxidase is of major importance in the IRI of skin flaps