Towards Optimizing Sub-Normothermic Machine Perfusion in Fasciocutaneous Flaps: A Large Animal Study.
Towards Optimizing Sub-Normothermic Machine Perfusion in Fasciocutaneous Flaps: A Large Animal Study.
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DOI：
10.3390/bioengineering10121415
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发表时间：
2023-12-12
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机器灌注自首次应用于实体器官移植以来，发展迅速。同样地，重建手术也跟上了步伐，离体灌注似乎是血管化复合同种异体移植物保存的新趋势。在自体重建中，筋膜皮瓣由于其低发病率（肌肉保留）和良好的功能和美容效果，现在是金标准。然而，由于在游离皮瓣转移过程中遇到的血管困难，偶尔仍会出现失败。机器灌注程序的发展将有可能在某些复杂病例中暂时替代甚至避免显微外科手术。我们在猪模型中进行了24和48 h的筋膜皮瓣的氧合脱细胞亚常温灌注，并比较了连续和间歇灌注方案。监测的指标包括血管阻力、水肿、动静脉氧气差异和代谢参数。进行最终组织学评估。成功进行充氧灌注的猪皮瓣在灌注结束时显示出极轻微或无细胞坏死迹象。间歇灌注允许在24小时和延长的灌注持续时间获得总体更好的结果。这项工作为进一步的研究提供了坚实的基础，并可能导致新的可靠的重建技术。
Machine perfusion has developed rapidly since its first use in solid organ transplantation. Likewise, reconstructive surgery has kept pace, and ex vivo perfusion appears as a new trend in vascularized composite allotransplants preservation. In autologous reconstruction, fasciocutaneous flaps are now the gold standard due to their low morbidity (muscle sparing) and favorable functional and cosmetic results. However, failures still occasionally arise due to difficulties encountered with the vessels during free flap transfer. The development of machine perfusion procedures would make it possible to temporarily substitute or even avoid microsurgical anastomoses in certain complex cases. We performed oxygenated acellular sub-normothermic perfusions of fasciocutaneous flaps for 24 and 48 h in a porcine model and compared continuous and intermittent perfusion regimens. The monitored metrics included vascular resistance, edema, arteriovenous oxygen gas differentials, and metabolic parameters. A final histological assessment was performed. Porcine flaps which underwent successful oxygenated perfusion showed minimal or no signs of cell necrosis at the end of the perfusion. Intermittent perfusion allowed overall better results to be obtained at 24 h and extended perfusion duration. This work provides a strong foundation for further research and could lead to new and reliable reconstructive techniques.
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影响因子：
4
作者：
Goudot, Guillaume;Berkane, Yanis;de Clermont-Tonnerre, Eloi;Guinier, Claire;von Reiterdank, Irina Filz;van Kampen, Antonia;Uygun, Korkut;Cetrulo, Curtis L.;Uygun, Basak E.;Dua, Anahita;Lellouch, Alexandre G.
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Lellouch, Alexandre G.
影响因子：
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1.2
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3.5
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Ulrich, Dietmar J. O.
影响因子：
1.2
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Haug, Valentin;Kollar, Branislav;Pomahac, Bohdan
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Pomahac, Bohdan