Preventing flap necrosis with adrenomedullin and glucagon-like peptide-1

Abstract

Many factors are known to play a role in flap necrosis, such as inadequate blood flow and disturbed venous drainage, which lead to decreased flap nutrition and necrosis. The aim of this study was to determine whether adrenomedullin (ADM) and glucagon-like Peptide-1 (GLP-1) administered at various doses directly to the superficial inferior epigastric artery (SIEA) had an effect on the normal healing process of flap tissue. Methods. Under 3% isoflurane anesthesia, the rats were put in the dorsal decubitus position before the surgery. A cutaneous flap 8 cm x 3 cm in size was marked on the abdominal wall, divided into four equal sections, and marked from 1 to 4 (proximal to distal). A laser Doppler flowmeter was used to measure the blood supply of each area in the flap tissue. On the seventh postoperative day, an image of the final condition of the flap was obtained with a 5-megapixel camera; the rats were sacrificed afterward. Results. Groups treated with ADM or GLP-1 showed a statistically significant increase in the blood flow of the four separate regions compared to the saline group. The percent necrosis area decreased in a statistically significant manner in the groups treated with ADM and GLP-I. Conclusion. The authors believe that both peptides play an important role in the normal flap recovery process.