Tissue-plasminogen activator restores muscle flap perfusion in the rat

This study was designed to evaluate the effect of tissue-plasminogen activa tor on skeletal muscle flap perfusion after a thrombogenic insult. Twenty-f our male Sprague-Dawley rats were divided into 4 experimental groups of 6 a nimals each. In group 1 (sham), the cremaster muscle was isolated as an end -organ flap. In group 2, after cremaster muscle isolation, a semicircular i nverted suture as a thrombogenic insult was performed at the ipsilateral co mmon iliac artery. In group 3, local tissue-plasminogen activator infusion followed the inverted suture. In group 4, vehicle was infused. After 24 hou rs, the cremaster muscle flap hemodynamics and leukocyte-endothelia; intera ctions were measured using intravital microscopy. Capillary perfusion signi ficantly decreased after the inverted suture from a median of 6.23 (group 1 ) to 1.50 (Group 2) functional capillaries per Visual field. Tissue-plasmin ogen activator significantly increased capillary perfusion after the thromb ogenic insult from a median of 1.50 (group 2)and 2.50 (group 4) to 6.00 (gr oup 3). Tissue-plasminogen activator restored capillary perfusion after a t hrombogenic insult to the main feeding artery. (J Hand Surg 1999;24A:1036-1 044. Copyright (C) 1999 by the American Society for Surgery of the Hand.)