Macrophage Migration Inhibitory Factor—An Innovative Indicator for Free Flap Ischemia after Microsurgical Reconstruction

Abstract

(1) Background: Nowadays, the use of microsurgical free flaps is a standard operative procedure in reconstructive surgery. Still, thrombosis of the microanastomosis is one of the most fatal postoperative complications. Clinical evaluation, different technical devices and laboratory markers are used to monitor critical flap perfusion. Macrophage migration inhibitory factor (MIF), a structurally unique cytokine with chemokine-like characteristics, could play a role in predicting vascular problems and the failure of flap perfusion. (2) Methods: In this prospective observational study, 26 subjects that underwent microsurgical reconstruction were observed. Besides clinical data, the number of blood leukocytes, CRP and MIF were monitored. (3) Results: Blood levels of MIF, C-reactive protein (CRP) and leukocytes increased directly after surgery. Subjects that needed surgical revision due to thrombosis of the microanastomosis showed significantly higher blood levels of MIF than subjects without revision. (4) Conclusion: We conclude that MIF is a potential and innovative indicator for thrombosis of the microanastomosis after free flap surgery. Since it is easy to obtain diagnostically, MIF could be an additional tool to monitor flap perfusion besides clinical and technical assessments.

Flap blood glucose measurement for flap monitoring and early detection of circulatory problems

“…Newer techniques such as Thermal scan and Macrophage Migration Inhibitory Factor are still under evaluation but are likewise expensive. 16 An ideal flap monitoring technique should be atraumatic, inexpensive; it should produce rapid, reliable, and objective results; it should be simple to interpret even by relatively inexperienced personnel; and it should be applicable to all types of flaps. 17 The flap blood glucose method is simple and can be performed by residents, nurses, and even patients themselves, even on intraoral flaps, which are almost impossible to monitor on the basis of flap colour or temperature.…”

“…Newer techniques such as Thermal scan and Macrophage Migration Inhibitory Factor are still under evaluation but are likewise expensive. 16…”

Apoptotic Bodies Derived from Fibroblast‐Like Cells in Subcutaneous Connective Tissue Inhibit Ferroptosis in Ischaemic Flaps via the miR‐339‐5p/KEAP1/Nrf2 Axis

“…Interestingly, among EV subtypes, ABs inherit the characteristics of blast cells to the greatest extent. [ 9 , 24 , 41 ] Considering the versatility of stem cells, whether ABs produced by stem cells promote tissue repair to a greater extent than FSCT cell‐derived ABs, such as those produced from adipose stem cells or bone marrow MSCs, remains to be determined. We demonstrated that FSCT cell‐derived ABs inhibited KEAP1 by delivering miR‐339‐5p.…”

The Role of Macrophage Migration Inhibitory Factor (MIF) and D-Dopachrome Tautomerase (D-DT/MIF-2) in Infections: A Clinical Perspective

“…The MIF cytokine family exerts a special role in infectious diseases and inflammations (see Table 1). Aside from its role in infectious diseases, MIF plays a role in inflammatory diseases such as asthma or atherosclerosis, various forms of cancer, several autoimmune diseases, burn injuries, wound healing, and even free-flap ischemia [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57]. The diverse functions of the MIF protein in the immune response of the organism to microbial pathogens have been demonstrated in various studies [37,39,41,58,59].…”