The effects of conjugated deferoxamine in porcine skin flaps

Background. The free radical scavenger, deferoxamine (DFO) has been shown t o reduce skin flap necrosis; however, its shortcomings are its toxicity and short plasma half-life. Methods. This study investigates the effects of the less toxic, longer acti ng conjugated form, DFO-Hespan (DFO-H), to ischemic porcine skin flaps. Dur ing the study, DFO-H plasma concentrations and flap viability were evaluate d over 10 days. Results. Steady DFO serum levels were maintained with no evidence of system ic side effects. However, DFO-H was not effective in increasing porcine ski n flap viability. Mean treated flap viability (n = 18) was 36.2% +/- 1.7% ( mean +/- SE) vs control (n = 16) 35.8% +/- 2.65%, p = .9. Conclusion. DFO-H conjugation increases its half-life and its systemic tole rance for DFO. However, this conjugation may also reduce DFO's effectivenes s to preserve flap survival probably by decreasing its ability to reach the intracellular oxygen free radicals. In addition, further studies are neede d to investigate whether longer DFO administration given postoperatively ca n be more effective in reducing ischemic injury. (C) 2000 John Wiley & Sons , Inc.