L. Birk-sorensen et al., Aprotinin attenuates platelet accumulation in ischaemia-reperfusion-injured porcine skeletal muscle, BL COAG FIB, 10(4), 1999, pp. 157-165
This purpose of this study was to evaluate the effect of aprotinin, a serin
e protease inhibitor, in ischaemia- and reperfusion-injured myocutaneous fl
aps and skin flaps. Flap survival, microcirculatory platelet accumulation,
and regional blood flow were investigated in seventeen pigs which had been
subjected to 8 h of ischaemia and 18 h of reperfusion. The pigs were random
ly assigned to aprotinin treatment (n = 9) or saline (n = 8). In-vitro stud
ies were performed to investigate the influence of aprotinin on the activat
ed partial thromboplastin time. The survival of skeletal muscle correlated
positively with the concentration of aprotinin (P = 0.02) and could not be
explained by regional changes in blood flow. Platelet accumulation was decr
eased in aprotinin-treated muscle (P = 0.04). In-vitro (n = 10), 100 kallik
rein inactivator units/ml aprotinin prolonged the activated partial thrombo
plastin time both in plasma (P = 0.001) and in blood (P = 0.002), suggestin
g an anticoagulant rather than a procoagulant effect. In conclusion, aproti
nin at high concentrations may be beneficial for the survival of skeletal m
uscle and provides protection from platelet accumulation in the microcircul
ation of skeletal muscle exposed to ischaemia and reperfusion injury. Blood
Coag Fibrinol 10:157-165 (C) 1999 Lippincott Williams & Wilkins.