Hyperoxygenated solution improves tissue viability in an avulsion injury flap model

Wang, Jianzhang; Tuo, ZhangQiang; Zhang, Juan; Guo, Ping; Song, Baoqiang

doi:10.1016/j.bjps.2019.11.029

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…After 3 days of flap elevation, Tsai et al (2015) observed evidence of coagulative necrosis and edema. Wang et al (2020) reported loss of tissue microarchitecture and disorganized dermal/epidermal layer after 7 days of ischemia in a skin flap avulsion model. After 14 days of flap elevation, Dogan et al (2021) observed absence of hair and sebaceous glands with degenerated epithelium in the distal tip (Figure 3).…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of pathologic markers in skin ischemia with and without reperfusion injury in microsurgical reconstruction: Biomarker alterations precede histological structure changes

Khalaf,

Duarte Bateman,

Reyes

et al. 2024

Microsurgery

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BackgroundIschemia and ischemia–reperfusion injury contribute to partial or complete flap necrosis. Traditionally, skin histology has been used to evaluate morphological and structural changes, however histology does not detect early changes. We hypothesize that morphological and structural skin changes in response to ischemia and IRI occur late, and modification of gene and protein expression are the earliest changes in ischemia and IRI.MethodsA systematic review was performed in accordance with PRISMA guidelines. Studies reporting skin histology or gene/protein expression changes following ischemia with or without reperfusion injury published between 2002 and 2022 were included. The primary outcomes were descriptive and semi‐quantitative histological structural changes, leukocyte infiltration, edema, vessel density; secondary outcomes were quantitative gene and protein expression intensity (PCR and western blot). Model type, experimental intervention, ischemia method and duration, reperfusion duration, biopsy location and time point were collected.ResultsOne hundred and one articles were included. Hematoxylin and eosin (H&E) showed inflammatory infiltration in early responses (12–24 h), with structural modifications (3–14 days) and neovascularization (5–14 days) as delayed responses. Immunohistochemistry (IHC) identified angiogenesis (CD31, CD34), apoptosis (TUNEL, caspase‐3, Bax/Bcl‐2), and protein localization (NF‐κB). Gene (PCR) and protein expression (western blot) detected inflammation and apoptosis; endoplasmic reticulum stress/oxidative stress and hypoxia; and neovascularization. The most common markers were TNF‐α, IL‐6 and IL‐1β (inflammation), caspase‐3 (apoptosis), VEGF (neovascularization), and HIF‐1α (hypoxia).ConclusionThere is no consensus or standard for reporting skin injury during ischemia and IRI. H&E histology is most frequently performed but is primarily descriptive and lacks sensitivity for early skin injury. Immunohistochemistry and gene/protein expression reveal immediate and quantitative cellular responses to skin ischemia and IRI. Future research is needed towards a universally‐accepted skin injury scoring system.

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Section: Resultsmentioning

confidence: 99%

Section: Prolonged Ischemia and Iri Lead To Tissue Edema And Epiderma...mentioning

confidence: 96%

Systematic review of pathologic markers in skin ischemia with and without reperfusion injury in microsurgical reconstruction: Biomarker alterations precede histological structure changes

Khalaf,

Duarte Bateman,

Reyes

et al. 2024

Microsurgery

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“…Preventing ischemia-related cell damage is a key challenge when preserving tissue extracorporeally for transplantation or replantation [1][2][3][4]. Presently, ischemically stored tissue is routinely kept under hypothermia to postpone ischemic damage [5] but the tissue's time of survival is still very limited, especially if muscle tissue is involved [6].…”

Section: Introductionmentioning

confidence: 99%

Tissue Viability of Free Flaps after Extracorporeal Perfusion Using a Modified Hydroxyethyl Starch Solution

Taeger

Friedrich

Horch

et al. 2020

JCM

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Background: In free flap surgery, tissue is stored under hypothermic ischemia. Extracorporeal perfusion (EP) has the potential to extend storage time and the tissue’s perspective of survival. In the present study, the aim is to improve a recently established, simplified extracorporeal perfusion system. Methods: Porcine musculus rectus abdominis were stored under different conditions. One group was perfused continuously with a simplified one-way perfusion system for six hours, while the other received only a single flush but no further treatment. A modified hydroxyethyl starch solution was used as a perfusion and flushing solution. Vitality, functionality, and metabolic activity of both groups were analyzed. Results: Perfused muscles, in contrast to the ischemically stored ones, showed no loss of vitality and significantly less functionality loss, confirming the superiority of storage under continuous perfusion over ischemic storage. Furthermore, in comparison to a previous study, the results were improved even further by using a modified hydroxyethyl starch solution. Conclusion: The use of EP has major benefits compared to the clinical standard static storage at room temperature. Continuous perfusion not only maintains the oxygen and nutrient supply but also removes toxic metabolites formed due to inadequate storage conditions.

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A novel NIR-II nanoprobe for precision imaging of micro-meter sized tumor metastases of multi-organs and skin flap

Lou

Ji²,

Qu³

et al. 2022

Chemical Engineering Journal

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Hyperoxygenated solution improves tissue viability in an avulsion injury flap model

Cited by 4 publications

References 24 publications

Systematic review of pathologic markers in skin ischemia with and without reperfusion injury in microsurgical reconstruction: Biomarker alterations precede histological structure changes

Systematic review of pathologic markers in skin ischemia with and without reperfusion injury in microsurgical reconstruction: Biomarker alterations precede histological structure changes

Tissue Viability of Free Flaps after Extracorporeal Perfusion Using a Modified Hydroxyethyl Starch Solution

A novel NIR-II nanoprobe for precision imaging of micro-meter sized tumor metastases of multi-organs and skin flap

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