Development of an Extracorporeal Perfusion Device for Small Animal Free Flaps.
Development of an Extracorporeal Perfusion Device for Small Animal Free Flaps.
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DOI：
10.1371/journal.pone.0147755
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Mücke T
中科院分区：
文献类型：
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作者：
Fichter AM;Ritschl LM;Borgmann A;Humbs M;Luppa PB;Wolff KD;Mücke T
体外灌注（ECP）可能会延长复合游离皮瓣的重要储存能力，从而可能开辟广泛的临床应用。本研究的目的是开发一种经过验证的低成本体外灌注模型，用于小动物游离皮瓣的进一步研究。建立最佳灌注设置后，一个专门设计的体外灌注系统进行了评估，在8小时灌注大鼠上腹部皮瓣，然后微血管游离皮瓣转移。对照组包括假手术、缺血和体内灌注。通过血气分析、激光多普勒血流仪和缓解光谱法以及吲哚青绿血管造影术密切监测皮瓣和灌注液（稀释血液）。通过在第7天评估坏死面积和光学显微镜检查来补充评价。建立ECP并在恒定的钾和pH水平下维持8小时。后续皮瓣转移成功。值得注意的是，体外灌注皮瓣的坏死率（27%）甚至低于体内灌注后的坏死率（49%），尽管没有统计学意义（P = 0.083）。假手术后，只有6%的总皮瓣面积坏死，而8小时缺血导致总皮瓣损失（98%）。血管造影和组织学结果证实了这些观察结果。暂时性体外循环可延长微血管皮瓣的重要储存能力。我们的研究为体外组织灌注过程中的病理生理过程提供了重要的见解，并为进一步的研究提供了一个有效的小动物灌注模型。
Extracorporeal perfusion (ECP) might prolong the vital storage capabilities of composite free flaps, potentially opening a wide range of clinical applications. Aim of the study was the development a validated low-cost extracorporeal perfusion model for further research in small animal free flaps. After establishing optimal perfusion settings, a specially designed extracorporeal perfusion system was evaluated during 8-hour perfusion of rat epigastric flaps followed by microvascular free flap transfer. Controls comprised sham-operation, ischemia and in vivo perfusion. Flaps and perfusate (diluted blood) were closely monitored by blood gas analysis, combined laser Doppler flowmetry and remission spectroscopy and Indocyanine-Green angiography. Evaluations were complemented by assessment of necrotic area and light microscopy at day 7. ECP was established and maintained for 8 hours with constant potassium and pH levels. Subsequent flap transfer was successful. Notably, the rate of necrosis of extracorporeally perfused flaps (27%) was even lower than after in vivo perfusion (49%), although not statistically significant (P = 0,083). After sham-operation, only 6% of the total flap area became necrotic, while 8-hour ischemia led to total flap loss (98%). Angiographic and histological findings confirmed these observations. Vital storage capabilities of microvascular flaps can be prolonged by temporary ECP. Our study provides important insights on the pathophysiological processes during extracorporeal tissue perfusion and provides a validated small animal perfusion model for further studies.
影响因子：
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作者：
Van Ginkel RJ;Van Berlo CL;Baas PC;Koops HS;Stuling RV;Elstrodt J;Hoekstra HJ
通讯作者：
Hoekstra HJ