PURINE METABOLISM DURING MICROSURGICAL TRANSFER OF HUMAN SKELETAL-MUSCLE

The effect of ischaemia followed by reperfusion on energy metabolism w as studied in human skeletal muscle after microsurgical free transfer. Muscle biopsy specimens from 11 patients treated by free muscle trans fer for facial palsy, injury to an extremity, or scalp defect were stu died. The biopsy specimens were taken during ischaemia and after one h our of reperfusion, respectively. They were analysed for ATP to uric a cid and creatine phosphate by high pressure liquid chromatography. Isc haemia lasting one or two hours affected the energy metabolism of the muscle cell as evidenced by a 50% reduction in creatine phosphate; a 2 0% reduction in ATP and in the energy charge; a 100% increase in inosi ne monophosphate, and a 700% increase in hypoxanthine and xanthine. Re perfusion for one hour improved these figures somewhat, and induced th e production of uric acid. Skeletal muscle can therefore tolerate isch aemia for up to two hours in the clinical situation without permanent damage to the tissues.