Effect of clamp versus anastomotic-induced ischemia on critical ischemic time and survival of rat epigastric fasciocutaneous flap

Chafin, Brett; Belmont, Michael J.; Quraishi, Huma; Clovis, Nina; Wax, Mark K.

doi:10.1002/(sici)1097-0347(199905)21:3<198::aid-hed3>3.0.co;2-t

Cited by 18 publications

(14 citation statements)

References 22 publications

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“…In our study, the surgical procedure was performed by microsurgical anastomoses to induce I/R injury. Although it is a time-consuming procedure that requires fine microsurgical skills, flaps undergoing anastomoses are more resistant to ischemia than those undergoing clamping [52]. Moreover, our surgical methodology is more translatable to a clinical scenario in free flap surgery.…”

Section: Discussionmentioning

confidence: 99%

Ischemia-reperfusion injury in a rat microvascular skin free flap model: A histological, genetic, and blood flow study

et al. 2018

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Ischemia reperfusion injury is associated with tissue damage and inflammation, and is one of the main factors causing flap failure in reconstructive microsurgery. Although ischemia-reperfusion (I/R) injury is a well-studied aspect of flap survival, its biological mechanisms remain to be elucidated. To better understand the biological processes of ischemia reperfusion injury, and to develop further therapeutic strategies, the main objective of this study was to identify the gene expression pattern and histological changes in an I/R injury animal model. Fourteen rats (n = 7/group) were randomly divided into control or ischemia-reperfusion group (8 hours of ischemia). Microsurgical anastomoses were objectively assessed using transit-time-ultrasound technology. Seven days after surgery, flap survival was evaluated and tissue samples were harvested for anatomopathological and gene-expression analyses.The I/R injury reduced the survival of free flaps and histological analyses revealed a subcutaneous edema together with an inflammatory infiltrate. Interestingly, the Arginase 1 expression level as well as the ratio of Arginase 1/Nitric oxide synthase 2 showed a significant increase in the I/R group. In summary, here we describe a well-characterized I/R animal model that may serve to evaluate therapeutic agents under reproducible and controlled conditions. Moreover, this model could be especially useful for the evaluation of arginase inhibitors and different compounds of potential interest in reconstructive microsurgery.

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Section: Discussionmentioning

confidence: 99%

Ischemia-reperfusion injury in a rat microvascular skin free flap model: A histological, genetic, and blood flow study

et al. 2018

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“…This experimental study has been performed according to a previously described model of rat epigastric skin free flap. [31][32][33] Critical ischemic time is the maximum ischemic insult that tissue can undergo preserving its viability. Critical ischemic time is dependent on the methodology used to induce ischemia.…”

Section: Discussionmentioning

confidence: 99%

“…Although experimental clamping studies of tissue flaps are often performed to simulate anastomosis, these experimental studies may not be closely translated to clinical settings where microsurgical anastomoses are performed. 31 Our experimental study is based on a free flap model with microvascular anastomoses which is somehow more extrapolable to a clinical scenario. Additionally, we have used a heparinized washout solution to mechanically remove stagnant blood from the microcirculation and to avoid secondary thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Adipose-Derived Stem Cells Ameliorate Ischemia-Reperfusion Injury in a Rat Skin Free Flap Model

Ballestín

Casado

Abellán

et al. 2018

J reconstr Microsurg

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“…[6][7][8][9][10] The main reason for this difference may be due to the difference in the method of producing ischemia in each experiment model. Chafin et al 12 reported that skin flaps undergoing ligation and anastomosis were more resistant to ischemia than those undergoing clamping of the pedicle using the rat epigastric flap model. Using the rat model, the critical time was 2 or 3 hr of ischemia in the clamp model, 8,9 and was 8 hr of ischemia in the isograft model, 7 in which ligation and anastomosis of the vascular pedicle were performed.…”

Section: Discussionmentioning

confidence: 99%

Role of Simple Cold Storage in Preventing Epiphyseal Growth Plate Impairment after Replantation Surgery in Immature Rats

Sunagawa

Ishida²,

Ikuta³

et al. 2005

J reconstr Microsurg

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The purpose of this study was to investigate the effect of ischemia time on longitudinal bone growth after replantation, and to evaluate the usefulness of simple cold storage of an amputated limb in preventing epiphyseal growth-plate impairment. A hind-limb replantation model was produced with 5-week-old rats after various ischemia times. With more than 6 hr of warm ischemia, growth disturbance was observed, and extensive necrosis was histologically apparent in the central region of the growth plate of the proximal tibia, even at 1 week postoperatively. Destruction of the growth plate was complete at 4 weeks after surgery. By simple cold storage of the amputated limb, growth disturbance was not observed, even following ischemia for 9 hr, and no abnormal findings were observed histologically. Segmental necrosis and destruction of the growth plate observed histologically suggested the possibility of indirect impairment of the epipyseal chondrocytes due to disturbance of the epiphyseal arterial system, attributable to ischemia. The study confirmed experimentally that cold storage of the amputated part may prevent longitudinal bone-growth disturbance after extension of ischemia time.

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Effect of clamp versus anastomotic-induced ischemia on critical ischemic time and survival of rat epigastric fasciocutaneous flap

Cited by 18 publications

References 22 publications

Ischemia-reperfusion injury in a rat microvascular skin free flap model: A histological, genetic, and blood flow study

Ischemia-reperfusion injury in a rat microvascular skin free flap model: A histological, genetic, and blood flow study

Adipose-Derived Stem Cells Ameliorate Ischemia-Reperfusion Injury in a Rat Skin Free Flap Model

Role of Simple Cold Storage in Preventing Epiphyseal Growth Plate Impairment after Replantation Surgery in Immature Rats

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