The beneficial antiinflammatory effect of dexamethasone administration prior to reperfusion on the viability of cold-stored skin flaps

The main purpose of this study was to investigate the possible protective e ffect of a single dose of glucocorticoid dexamethasone administered just be fore reperfusion on the viability of cold-stored inferior epigastric rat sk in flaps. We also sought evidence for the antiinflammatory mechanism of act ion of dexamethasone involved in this model of cold ischemia-reperfusion. T he viability of flaps on reperfusion day 7, after 1, 2, 3, 4, or 5 days of cold ischemia, was 80, 74, 60, 47 and 12% respectively. Four days' cold isc hemia lime was chosen to test the effect of intraperitoneal dexamethasone a dministration (2.5 mg/kg) 30 min prior to reperfusion. Flap survival after 4 days' cold ischemia/7 days' reperfusion increased significantly from a me an of 37.0% survival in saline-treated controls to 73.3% in dexamethasone-t reated rats (p <0.05). Dexamethasone treatment also resulted in significant ly lower skin nap water content ja measure of edema) and myeloperoxidase ac tivity tan indicator of neutrophil infiltration) but had no significant eff ect on skin levels of hydroperoxides (a measure of free radical activity). in conclusion, dexamethasone attenuates ischemia-reperfusion injury in cold -stored skin flaps by reducing the tissue levels of several proinflammatory mediators.