ABSTRACT
Superoxide radicals were measured in the blood of six patients who underwent vascular
reconstruction after ischemic injury in an attempt to predict prognosis following
surgery. Three free-tissue transfers (two free latissimus dorsi flaps, one free vascularized
fibular osteocutaneous graft) were performed on patients with skin or bone defects
associated with open tibial fractures. Vascular reconstructions were performed on
two patients with popliteal vascular injuries, in one case with an open femoral fracture
and in another with an open knee dislocation. A third vascular reconstruction was
performed on a patient with a subclavian artery injury associated with a clavicular
fracture. Superoxide levels in the blood were quantified by a chemilumi-nescence method
using a derivative of luciferin. Blood was obtained prior to reperfusion and periodically
to 72 hr postoperatively. In patients who underwent successful reconstructions, superoxide
levels increased after reperfusion. Vascular insufficiency was associated with acute
drops in superoxide concentrations.
Superoxide levels are a promising clinical marker which can predict insufficiency
during reperfusion following tissue ischemia.
