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KMID : 0603119970060010001
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Journal of the Korean Microsurgical Society
1997 Volume.6 No. 1 p.1 ~ p.8
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Effect of Prostaglandin E1 on Cutaneous Microcirculation of Flap or Replantation
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Hideki Nakanishi
Ichiro Hashimoto/Shinji Tanaka
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Abstract
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Recently prostaglandin E1(PGE1) has been shown to ensure flap survival by producing vasodilation of the peripheral vessels and platelet disaggreation. However, direct observation and detailed quantitative studies of the effects of PGE1 on the cutaneous microcirculation have not been reported. In the present study, we investigated cutaneous microcirculatory changes in the rabbit ear chamber(REC) with an intravital microscope following intravenous administration of PGE1. The results obtained in this study indicate that PGE1 administered intravenously at a rate of 200ng/kg/min might act directly on the vessels and cause dilatation of metarterioles and capillaries without affecting vasomotion and systemic blood pressure. Clinically in order to evaluate the effect of an intravenous administration of PGE1 on the cutaneous microcirculation, cutaneous blood flow, skin temperature and transcutaneous Po2 in the pedicle or free flap of operated patients were evaluated by the combination of several measurements following the administration of PGE1. The present study suggests that improvement of cutaneous microcirculation by PGE1 may enhance the survival rate of flap or replantation. Both vessel arterial ischemia and venous congestion are main factors of tissue necrosis in the flap surgery. Vasodilatory or antithrombotic agents have been used in salvage of flap necrosis. However, the therapeutic effects of those drugs are still not well elucidated. Recently prostaglandin E1(PGE1) has been shown to ensure flap survival by producing vasodilatation of the peripheral vessels and platelet disaggregation[1-3]. Emerson and sykes[4] have obtained significant improvement in the flap survival in the rat using PGI2. Suzuki et al.[5] have reported prolonged flap survival length by using PGE1 in the rabbit and concluded that PGE1 improved the microcircuration in the flap. However, direct observation and detailed quantitative studies of the effects of PGE1 on the cutaneous microcirculation have not been reported. In the present study, we investigated microcirculatory changes in the rabbit ear chamber[6,7] with an intravital microscope following intravenous administration of PGE1.
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