Augmentation of experimental skin flap survival via postoperative phosphocreatine replacement

Charles B. Cuono, Andres Cortes, Ralph Marquetand, Verne Weisberg, Ian M. Armitage

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Despite improvements in our understanding of cutaneous vascular territories, clinical skin flap necrosis resulting from ischemic compromise is still a reality. Therapy with vasodilators has been generally unsuccessful, but replacement of high-energy phosphometabolites through the use of ATP-MgCl2 and fructose 1,6-diphosphate has been effective. Recently we reported that phosphocreatine is the major high-energy phosphometabolite in mammalian skin and that ATP levels and cellular well-being in skin flaps are dependent on adequate supply of this phosphometabolite. We report herein the successful augmentation of survival of ischemically compromised skin flaps through postoperative phosphocreatine infusion. This metabolite effectively circumvents the nonfunctioning mitochondrial creatine-phosphocreatine energy shuttle without disturbing the delicate [ATP] [ADP] balance in the cytosol. In addition, phosphocreatine may favorably redistribute blood flow from muscle to the ischemically compromised skin.

Original languageEnglish (US)
Pages (from-to)263-268
Number of pages6
JournalSurgery
Volume102
Issue number2
StatePublished - Aug 1987

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