Effects of Dabigatran and Fondaparinux on Degloving Injuries, An Experimental Study

Ural, Alper; Bilgen, Fatma; Aykan, Duygun Altıntaş; Bahar, Abdülkadir Yasir; Bekerecioğlu, Mehmet; Ural, Dilan Altıntaş

doi:10.14744/tjtes.2020.26678

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…In the clinical setting, many avulsed-skin samples can survive intact via in situ suturing and drug administration. 18 Abundant perforators in this area probably served as pedicles sufficient to supply the avulsed flap in this porcine model. In order to generate a stable partial-necrosis model, four measures were taken.…”

Section: Discussionmentioning

confidence: 87%

NIR-II Fluorescence Imaging Using Indocyanine Green Provides Early Prediction of Skin Avulsion-Injury in a Porcine Model

Gao¹,

Yu²,

Wang³

et al. 2022

CCID

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Purpose Currently, skin avulsion–injury reconstruction is mainly based on subjective evaluation of traditional clinical signs. It frequently results in unnecessary tissue loss and incomplete debridement-related infection. This pilot study aimed to develop a novel near-infrared (NIR) II fluorescence imaging method to assess avulsed skin–perfusion status and thus predict its outcome early. Methods Skin avulsion–injury models were established by avulsing 10×4 cm pedicled flaps on porcine hindlimbs. A clinically available improved NIR-Ι/II multispectral imaging system was applied for NIR imaging using indocyanine green (ICG) fluorescence. Continuous NIR-wavelength filters and dynamic imaging were used to investigate optimal imaging conditions and time window. NIR-Ι/II imaging was synchronously conducted for quality comparison of the two methods. Visual inspection and histological studies were used for assessing the final outcome of avulsed skin. Results NIR-II fluorescence imaging with a 1,100 nm filter obtained satisfactory performance and reached maximum fluorescence intensity at 1 minute after ICG injection. NIR-II imaging clearly visualized the microvascular network in vascularized avulsed skin and revealed “dark areas” in nonvascularized avulsed skin in a real-time fashion. NIR-II fluorescence imaging demonstrated higher resolution than NIR-I imaging, as indicated by ae higher signal-to-background ratio (2.11) and lower full width at half maximum (6.50614). The dark area of avulsed skin on imaging finally developed to necroses that were confirmed by histology. Conclusion NIR-II real-time fluorescence imaging clearly maps the microvascular network and shows the perfusion status of avulsed skin at higher resolution than traditional NIR-I imaging, and thus precisely predicts the outcome of avulsed skin early.

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Section: Discussionmentioning

confidence: 87%

NIR-II Fluorescence Imaging Using Indocyanine Green Provides Early Prediction of Skin Avulsion-Injury in a Porcine Model

Gao¹,

Yu²,

Wang³

et al. 2022

CCID

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show abstract

Section: Discussionmentioning

confidence: 99%

“…can be used to deal with the problem, but debridement and soft tissue reconstruction may be optimal choices for another situations. 5 , 26 Therefore, it is very important for treatment option selection to evaluate the extent of the injury based on the assessment of microvessels. Although the condition has shown the need for a reliable technique reflecting true physiological and pathological behaviors of cutaneous circulation, the effective imaging modalities for prediction of tissue necrosis in skin avulsion injuries remain largely limited.…”

Section: Discussionmentioning

confidence: 99%

Photoacoustic Microscopy Provides Early Prediction of Tissue Necrosis in Skin Avulsion Injuries

Zhang¹,

Yuan²,

Zhang³

et al. 2021

CCID

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Background: Skin avulsion injuries caused by high-energy traffic and machinery accidents are important topics in the field of repair and reconstruction. The injury generates a skin flap with uncertain vascular basis resulting in ischemic necrosis of the distal portion of the flap. Yet there is lack of reliable way for estimating the extent of blood supply in damaged tissue, which has limited the possibility of prompt surgical intervention. Recent studies have confirmed that photoacoustic microscopy imaging has a wide range of applications in the biomedical field owing to its good performance in angiography. Methods: In our study, we successfully surgically induced skin avulsion injury on mice hindlimbs. Then, we used this novel approach to image skin microcirculation and predict skin necrosis with impaired blood supply after injury in live mice. Results and Conclusion:All skin tissues in the avulsed hindlimb flap group show different levels of necrosis at the end of the observation period. The "dark zone" with impaired microcirculation in PAM images, which continuously extends over time, was seen as a prediction of necrosis of skin tissue and at 60 min after surgery was similar to the area of clinical necrosis on postoperative day 7. All these indicate that photoacoustic microscopy imaging is a feasible, precise, high-resolution, non-invasive technique for early prediction of necrosis in skin avulsion injury, providing a promising tool for surgeons to manage the injury.

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Serum TNF-α and IL-10 levels during chronic carrageenan inflammation with thrombin inhibitor administration in rats

Shevchenko,

Pavlova

2024

Regul. Mech. Biosyst.

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Inflammatory cytokines are key mediators involved in the activation of the blood coagulation system, influencing various coagulation mechanisms, while activated coagulation proteases, physiological anticoagulants, and fibrinolytic system components can, conversely, modulate inflammation through specific cellular receptors. This study investigated the impact of the thrombin inhibitor dabigatran etexilate on a rat model of secondary chronic aseptic inflammation induced by an intramuscular injection of 10 mg of λ-carrageenan in 1 mL of isotonic saline into the right thigh of rats. Dabigatran etexilate was administered intragastrically via gavage at a dose of 15 mg/kg/day in 1 mL of isotonic saline daily for 28 days. Peripheral blood samples were collected on days 0, 1, 7, 14, 21, and 28 to determine serum TNF-α and IL-10 levels. During the natural course of secondary chronic carrageenan-induced inflammation, serum TNF-α levels increased until day 14 and subsequently decreased gradually towards day 28. Serum IL-10 levels during the natural course rose until day 21, followed by a slight drop on day 28. The administration of dabigatran etexilate modulated these cytokine dynamics, leading to a reduction in TNF-α levels compared to the natural course, particularly on days 14 and 21. Notably, IL-10 levels were significantly higher from day 1 to day 21 during dabigatran etexilate administration and exhibited a biphasic response, with a significant peak on day 7 and the highest levels observed on day 21. These distinct TNF-α and IL-10 level dynamics suggest a strong interaction between proinflammatory and anti-inflammatory processes. Dabigatran etexilate influenced the cytokine profile during chronic inflammation, potentially mitigating the inflammatory response as evidenced by the altered TNF-α and IL-10 levels. These findings highlight the potential of thrombin inhibitors, specifically dabigatran etexilate, in modulating inflammatory responses, warranting further investigation into its therapeutic mechanisms. Future research should focus on exploring the specific mechanisms through which dabigatran etexilate, and potentially other thrombin inhibitors, exert their anti-inflammatory effects, including their influence on humoral mediators relevant to the pathogenesis of chronic inflammation.

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Effects of Dabigatran and Fondaparinux on Degloving Injuries, An Experimental Study

Cited by 3 publications

References 14 publications

NIR-II Fluorescence Imaging Using Indocyanine Green Provides Early Prediction of Skin Avulsion-Injury in a Porcine Model

NIR-II Fluorescence Imaging Using Indocyanine Green Provides Early Prediction of Skin Avulsion-Injury in a Porcine Model

Photoacoustic Microscopy Provides Early Prediction of Tissue Necrosis in Skin Avulsion Injuries

Serum TNF-α and IL-10 levels during chronic carrageenan inflammation with thrombin inhibitor administration in rats

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