OXIDATIVE STRESS AND ANTIOXIDANT SYSTEM IN SEVERE UPPER LIMB INJURIES

Abstract

Objective: To evaluate lipid peroxidation (LPO) and antioxidant defense (AOD) system in severe upper limb injury (SULI) with skin defects covered with autografts Methods: LPO and AOD system were evaluated in 32 patients after urgent surgical intervention for SULI. The patients were divided into two groups: Group I (main) included 16 patients who underwent reconstructive surgery and antioxidant therapy, and Group II included 16 operated patients who did not receive antioxidant treatment. There were 22 men and 10 women enrolled in the study; the age of the patients varied between 19-51 years, and the average age was 29.2 years. Patients of both groups underwent reconstructive surgery with soft tissue traumatic defects covered with autografts. In both groups, malondialdehyde (MDA) and superoxide dismutase (SOD) were tested in the blood serum before surgery and on the 7th day after surgery. In the main group, patients received a course of antioxidant treatment immediately in the postoperative period for 7 days, while the control group patients did not receive this therapy. Results: The MDA values before surgery in Groups I and II were similar comprising 3.23±0.41 and 3.35±0.37 µmol/l, respectively. After surgery, there was a considerable decrease in the level of MDA in both groups (p 0.001), however, in Group I this decrease was more significant compared to Group II (1.86±0.32 µmol/l vs. 2.78±0 .43 µmol/l, p 0.001). Initially, the level of SOD in both clinical groups had no statistical differences (p 0.05), amounting to 10.6±2.4 u/ml and 10.2±1.8 u/ml, respectively. The level of SOD on the 7th day after the operation tended to increase in both groups, however, its more significant increase was noted in the main group compared with the control group (15.8±1.3 u/ml and 12.2±1.9 u/ml, respectively, p 0.001). Conclusion: SULI with skin defects is accompanied by oxidative stress and antioxidants depletion. The use of antioxidant therapy in the postoperative period largely eliminates the disbalance in the LPO-AOD system and improves the results of reconstructive surgeries in SULI. Keywords: LPO, AOD, MDA, SOD, upper limb injury, autotransplantation, antioxidant therapy.