Chapter 3 Table 3.1 Direct NO donors used in experimental flap models. Donor name Abbreviation Spermine NONOate Sper/NO Morpholinosydnonimine SIN‐1 S‐Nitrosated human serum albumin SNO‐HAS S‐nitroso‐glutathione GSNO In all experimental IR injury models using direct NO donors, flap viability was increased and was usually associated with a decreased neutrophil activation (Table 3.2).50,56,63,64 Kuo et al. demonstrated that with increase flap viability, there was also an inhibition of iNOS expression and a protective effect on eNOS expression.50 Khiabani et al., in accordance to the previous finding, demonstrated that following IR injury, there was a disruption of constitutive NOS expression and activity, which may lead to decreased NO production at reperfusion.65 Kuntscher et al.’s study demonstrated that the protective effect of NO donor only occurs when administrated prior to ischemia and was less effective when administered during ischemia or early in the reperfusion injury.64 Table 3.2 Experimental results using exogenous NO donor or L‐arginine. Author, Year NO donor or Physiologic effect Flap viability Flap model L‐arginine Komorowska‐ L‐arginine eNOS and iNOS Increased Axial pattern cutaneous flap, rat Timek, 200468,84 substrate Kuo, 20043 GSNO NO donation, Increased Axial pattern cutaneous flap, rat suppression of iNOS and protecting eNOS expression Zhou, 200471 L‐arginine eNOS and iNOS Increased Random pattern cutaneous flap, rat substrate Mittermayr, 200385 S‐NO‐HSA NO donation Increased Axial pattern cutaneous flap, rat Du, 200266 L‐arginine eNOS and iNOS Increased Random pattern cutaneous flap, rat substrate Khiabani, 200256 SIN‐1 NO donation Increased Myocutaneous flap, pig Kuntscher, 200264 Sper/NO NO donation Increased Cutaneous flap, rat Lovett, 200169 L‐arginine eNOS and iNOS Increased Axial pattern muscle flap, pig substrate Meldrum, 199963 L‐arginine eNOS and iNOS Increased Axial pattern muscle flap, rat substrate Cordeiro, 199858 L‐arginine eNOS and iNOS Increased Myocutaneous flap, pig substrate Ercocen, 199867 L‐arginine eNOS and iNOS Increased Random pattern cutaneous flap, rat substrate Um, 199870 L‐arginine eNOS and iNOS Increased Random pattern cutaneous flap, rat substrate Cordeiro, 199757 L‐arginine eNOS and iNOS Increased Random pattern cutaneous flap, rat substrate 46
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