Effect of Capsulectomy on the Hemodynamics and Viability of Random-Pattern Skin Flaps Raised on Expanded Skin in the Pig

Morris, Steven F.; Pang, Cho Y.; Mahoney, James; Lofchy, Neal; Kaddoura, Imad L.; Patterson, Robert B.; Lista, Frank

doi:10.1097/00006534-198908000-00020

Cited by 16 publications

(2 citation statements)

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“…A tissue expander inserted between the subcutaneous tissue and fascia serves to block the direct blood supply arising from underneath the flap; thus, a more severe condition is created in this model. This flap model is similar to a reported model, a bipedicled flap and pig flap including subcutaneous tissue, although the vascular supply is considered to be random but very stable, reproducible, and can be used for further experiments . Additionally, the expander plays a role in decreasing apoptotic cells in the epidermal‐dermal skin compared to intact normal skin.…”

Section: Discussionmentioning

confidence: 68%

The usefulness of basic fibroblast growth factor for radiation‐exposed tissue

Kinoshita

Tsuda

Hamuy

et al. 2012

Wound Repair Regeneration

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A high dose of ionizing external radiation damage to the skin and soft tissue results in changes in function as well as in the general body condition. Once radiation surpasses the tissue safety or survival level, progressive alteration in the damaged tissue results in tissue loss and then flap loss. Local expression and action of stem cells or local growth factors in the irradiated tissue is mitigated, and external administration is sought to investigate the possibility of skin and soft tissue survival after an elevating flap. Basic fibroblast growth factor (bFGF) is primarily considered as a potent angiogenic growth factor. In burns, resurfacing with a dermal component is required, and bFGF stimulates wound healing and enhances human skin-derived mesenchymal stem cells under serum-free conditions in a dose-dependent manner. Thirty-five male, 4- to 8-week-old CLAWN miniature pigs received radiation exposure to assess the effectiveness of bFGF in terms of the progressive clinical course relevant to human skin and soft tissue. At 2 weeks following 10-Gy irradiation, tissue was preserved in the group receiving subcutaneous placement of a round-type tissue expander and bFGF. The expander plus bFGF group demonstrated significantly greater dermo-epidermal proliferation than the radiation alone, radiation plus bFGF, or expander plus radiation plus vehicle-solution groups, and new blood vessel formation was significantly increased in the expander tissue with bFGF after irradiation (p < 0.01). Electron microscopy revealed that tissue with expander and bFGF maintained more stable skin adnexae with preserved intact epidermis and dermis. Thus, bFGF improved and maintained the tissue viability after immediate irradiation in the skin and soft tissue.

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Section: Discussionmentioning

confidence: 68%

The usefulness of basic fibroblast growth factor for radiation‐exposed tissue

Kinoshita

Tsuda

Hamuy

et al. 2012

Wound Repair Regeneration

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“…As demonstrated in other species (Austad & Rose, 1982), an obvious fibrous capsule was observed at the site of the STEs which increased the stiffness of the expanded skin and limited mobilisation of skin flaps in several of the cases in the present study. Capsulectomy appears not to have a detrimental effect on the vascular supply or survival of flaps using expanded tissue (Morris et al, 1989), but the procedure remains controversial amongst some surgeons (Provost & Bailey, 2019). A less invasive, and perhaps less controversial, approach involves careful scoring of the capsule of the expanded skin to preserve the blood supply of the expanded tissue, as was employed in the majority of the cases described.…”

Section: Discussionmentioning

confidence: 99%

Use of self‐inflating tissue expanders in equine surgery: A prospective study of 20 cases

Cullen¹,

Mair

Brennan³

et al. 2023

Equine Veterinary Education

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Summary Background Tissue expansion is a well‐established technique in reconstructive surgery. Self‐inflating tissue expanders (STE) have not been widely adopted by veterinary surgeons, and clinical descriptions of their use in horses are lacking. Objective To describe the indications, clinical experiences and outcomes of a series of equine cases that used a hydrogel‐based STE to assist soft tissue reconstruction. Study design Prospective clinical study. Methods Case details, surgical techniques and outcomes were recorded for horses requiring use of an STE, using a predesigned data collection sheet completed by the treating surgeon. All horses underwent two surgical procedures as part of their treatment: one to place the STE(s) and a second to remove the device(s) and perform reconstructive surgery using the expanded tissue. Results Twenty horses had STEs implanted at seven clinics and had sufficient follow‐up for inclusion in the study. Indications for using the expanders included the following: expansion of skin prior to excision of a neoplastic lesion (n = 13), repair of a sinocutaneous fistula (n = 2), repair of chronic scarring or a nonhealing wound (n = 2), repair of a full‐thickness ear pinna defect (n = 1) and repair of a rectovestibular injury (n = 2). The degree of tissue expansion was graded as good in 19/20 cases (95%) and provided sufficient tissue to cover the entire defect in 11/20 cases (55%). STE‐associated complications occurred in 9/20 horses (45%), but none of these complications were serious. The final clinical outcome was graded by the treating surgeon as good or excellent in 15/20 horses (75%). Main limitations Only one type of STE device is described, and its use was not compared with other treatments. Information regarding use of the STE at locations other than the head (n = 3) is limited. Conclusions Use of a STE device in horses resulted in no serious complications and provided a good outcome in a variety of equine clinical cases.

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Gewebeexpansion

Exner¹

2003

Plastische Chirurgie

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Effect of Capsulectomy on the Hemodynamics and Viability of Random-Pattern Skin Flaps Raised on Expanded Skin in the Pig

Cited by 16 publications

References 0 publications

The usefulness of basic fibroblast growth factor for radiation‐exposed tissue

The usefulness of basic fibroblast growth factor for radiation‐exposed tissue

Use of self‐inflating tissue expanders in equine surgery: A prospective study of 20 cases

Gewebeexpansion

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