| Objective: To investigate the changes of nitric oxide concentration in the distal portion of the random pattern skin flap and effect of exogenous L-arginine in survival of random pattern skin flap.Method: Cranially based random pattern skin flaps were elevated on the back of Wistar rats. The animals were divided into three groups: (1)L-Arginine treated group; (2)Saline treated group 1, with out skin flap formation; (3)Saline treated group 2. Image analysis technology was utilized to weigh the survival rate of the skin flaps and biochemistry method to measure the concentrations of NO in tissue. Histologic and immunohistochemistic method to observe the changes of tissue morphology and neutrophil counts and ICAM-1 expression in the distal portion of the flap.Result: Survival area of flap in the L-arginine-treated group significantly increased (63.83 5.13)% (p<0.01) compared with the control group (43.26 2.86)% at seven days postoperatively. Immediately after operation, NO concentrations in tissue were not obviously different in all groups (p>0.05). NO concentrations in control group began to decrease and then increase slightly, reached the top at the twelfth hour and slumped down to the bottom at the seventy-second hour. In L-arginine-treated group the changes were similar except for the extent. However, NO concentrations in L-arginine-treated group were in higher levels at sequential time after immediate time postoperatively (p<0.01, p<0.01, p<0.05 and p<0.01). Neutrophil counts in L-arginine-treated group were less (P<0.01) than that in saline treated group 2. Expression of ICAM-1 was stronger in saline treated group 2 immunohistochemically.Conclusion: After elevation of skin flaps, NO concentrations in skin flap tissues were up slightly and then down at early stage. And Exogenous L-arginine can promote NO concentration in random pattern skin flap tissues and protect skin flaps from ischemic injury through down regulation of ICAM-1 expression and reduction of neutrophil invasion. |
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