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    The Effect of Ceruloplasmin Against Ischemia-Reperfusion Injury in Epigastric Island Flap in Rats
    (Academic Press Inc., 2021) Seyid, Mircafer; Tiftikcioglu, Yigit; Erdem, Mehmet; Akdemir, Övünç; Tatar, Burak Ergün; Uyanıkgil, Yigit; Ercan, Gülinnaz
    Background: Flap surgery is frequently used in plastic surgery to close tissue defects. Ischemia-reperfusion (I/R) injury is a significant problem resulting in partial or total flap necrosis. This study aimed to investigate the effect of ceruloplasmin on I/R injury in epigastric island flaps in rats. Material and method: A total of 32 male Sprague-Dawley rats were divided into four groups with eight rats in each group: The flap was not elevated in Group I; the flap was elevated without ischemia or any application in Group II, after the intraperitoneal saline and ceruloplasmin application the flaps were elevated and ischemia was created in group III-IV, respectively. Bilateral epigastric artery flap was elevated in all groups except Group I. After 6 h of ischemia, the flap was reperfused and inset. Samples were taken from the right and left side of the flap area in other groups at the postoperative 24th h for biochemical analysis (catalase and malondialdehyde-MDA) and the seventh postoperative day for histopathological analysis (Modified Verhofstad score and epidermal thicknesses), respectively. Image analysis for necrosis areas was performed on photos taken on the 7th d. Results: Catalase level was significantly higher in Group IV.(0.15 ± 0.04 U/mg protein) (P < 0.05) Necrosis area percentage(14.4% ± 3.3%),MDA(3.6 ± 0.9 nmol/mg protein), edema(3), necrosis(2.75), and polymorphonuclear leukocyte infiltration(2.87) scores were significantly higher in group III.(P < 0.05). Fibroblast proliferation, collagen density (0.25), vascular density (0.25) scores and epidermal thickness (15.68 µm,) was significantly lower in group III. (P < 0.05) Conclusions: Our study demonstrated that ceruloplasmin application before ischemia reduced I/R injury in epigastric island flaps in rats. © 2021 Elsevier Inc.