Christina Mathew
Several vascular activities depend on the endothelium surface layer and endothelial glycocalyx. Various clinical situations, including significant surgery, can cause the glycocalyx to tear or shed. One potential "sheddase" has been suggested, and that is mast cell tryptase. Glycocalyx shedding during oncologic oral surgery may be harmful because it causes oedema in the musculocutaneous flap graft and a loss of vascular barrier function. In 16 patients having oncologic oral surgery, the blood serum concentrations of tryptase, heparan sulphate, and syndecan-1, as well as their levels before and after surgery, were determined. The concentrations of these compounds on postoperative day 1 and day 2 served as secondary measurements. During surgery, the level of heparan sulphate increased from 692 ng/mL. From 35 ng/mL to 138 ng/ mL, syndecan-1 levels increased. Tryptase levels were almost same before and after surgery, at 4.2 ng/mL and 4.2 ng/mL, respectively. During surgery, serum levels of syndecan-1 and heparan sulphate rose, indicating glycocalyx shedding. Tryptase levels remained constant, indicating that damage to the glycocalyx may have been caused by sheddases other than systemic tryptase release. A possible way to enhance flap viability and patient outcomes during oncologic oral surgery is to look into protective measures for the glycocalyx.