IMPACT OF HYPERTONIC-HYPERONCOTIC SALINE SOLUTIONS ON ISCHEMIA-REPERFUSION

这个子项目是利用资源的许多研究子项目之一。 由NIH/NCRR资助的中心拨款提供。对子项目的主要支持 子项目的首席调查员可能是由其他来源提供的， 包括美国国立卫生研究院的其他来源。为子项目列出的总成本可能 表示该子项目使用的中心基础设施的估计数量， 不是由NCRR赠款提供给次级项目或次级项目工作人员的直接资金。 调制成像组织光谱学研究高渗高麻醉盐水溶液对大鼠带蒂皮瓣缺血再灌注损伤的影响 组织转移瓣是一种将任何组织从身体的供体区域移动到受体部位的方法。重建外科医生使用两种主要类型的组织转移瓣，带蒂组织转移瓣和游离组织转移瓣。带蒂皮瓣由仅通过动脉和静脉连接到供区的软组织组成，为带蒂组织转移瓣提供血液供应。通过在动脉和静脉上旋转带蒂皮瓣的软组织，将带蒂皮瓣的组织从供体部位移动到受体部位，从而允许将组织从身体上的一个位置转移到另一个位置。在游离组织转移皮瓣中，动脉和静脉从供体部位分离出来，并使用显微外科技术重新连接到受体部位。外科技术的改进使得组织转移瓣修复创伤或肿瘤消融手术后的组织缺损的成功率很高。然而，由于血管机械性阻塞、全身性疾病或缺血再灌注(I/R)损伤所致的整体血供不足，仍有皮瓣失效的发生。这种I/R损伤直接发生在血流重建到缺血组织之后，这一过程在一定程度上发生在所有游离组织转移瓣上，因为在从供体部位脱离到在受体部位重新附着之间的时间段，皮瓣是一过性的缺血。如果带蒂皮瓣的血液供应因动脉和/或静脉在皮瓣上的“扭结”或外压而中断，也可能发生I/R损伤。严重的I/R损伤可导致组织转移皮瓣内的血管损伤，导致血流量减少和进一步的缺血，这可能导致部分或完全的皮瓣丢失。对于接受重建手术的患者来说，部分或全部的皮瓣丢失可能是毁灭性的。 高渗-高麻醉盐水(HHS)溶液是含有高浓度盐的溶液。先前的临床和动物研究发现，在重建缺血组织血流的同时给予HHS溶液可以减轻I/R损伤的程度和严重程度。本研究的目的是测试HHS溶液对缺血组织移植皮瓣血流量重建后I/R损伤的影响。我们假设这些解决方案能够最大限度地减少缺血组织血流恢复后I/R损伤的影响，从而提高总体皮瓣存活率。我们从之前的实验和结果中相信，在大鼠游离皮瓣模型中使用高渗盐水就是这种情况。本实验尝试使用调制成像(MI)光谱技术测量改进后的微血管血流量。我们计划通过使用MI波谱来显示高渗盐水处理后缺血皮瓣内总血红蛋白、氧合和脱氧血红蛋白的变化，以及缺血皮瓣内水分的变化。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. Impact of hypertonic-hyperoncotic saline solutions on ischemia-reperfusion injury in pedicled flaps in rats, as measured by Modulated Imaging tissue spectroscopy. Tissue transfer flaps are a method of moving any tissue from a donor area of the body to a recipient site. The reconstructive surgeon employs two major types of tissue transfer flaps, the pedicled tissue transfer flap and the free tissue transfer flap. A pedicle flap consists of soft tissues connected to the donor location only by the artery and vein, which provide the blood supply to the pedicled tissue transfer flap. The tissues of the pedicled flap are moved from the donor site to the recipient site by rotating the soft tissue of the flap on the arteries and veins, thereby allowing the transfer of tissue from one location to another on the body. In a free tissue transfer flap the arteries and veins are divided from the donor site, and re-attached to the recipient site using microsurgical techniques. Improved surgical techniques have resulted in a high percentage of successful tissue transfer flaps for tissue defects after trauma or oncological ablative surgery. However, flap failures still occur and are usually caused by global insufficiency of blood supply secondary to mechanical obstruction of the vessels, systemic disease, or the ischemia-reperfusion (I/R) injury. This I/R injury occurs directly after reestablishment of the blood flow to ischemic tissues, this process occurs to some extent with all free tissue transfer flaps as the flap is transiently ischemic during the period between detachment from the donor site and re-attachment at the recipient site. I/R injury can also occur with pedicle flaps as well if the blood supply to the flap is interrupted due to "kinking" or external compression of the arteries and / or veins to the flap. Severe I/R injury can result in vascular damage within the tissue transfer flap, leading to poor blood flow and further ischemia, which can result in partial or complete flap loss. Partial or complete flap loss can be devastating to patients undergoing reconstructive surgery. Hypertonic-hyperoncotic saline (HHS) solutions are solutions that contain high concentrations of salts. Prior clinical and animal studies have found that the administration of HHS solutions at the time of re-establishment of blood flow to ischemic tissue can lessen the extent and severity of I/R injury. The goal of this specific research project is to test the impact of HHS solutions on the I/R injury after re-establishment of blood flow to an ischemic tissue transfer flap. We hypothesize that these solutions are able to minimize the effects of I/R injury after the restoration of blood flow to ischemic tissues and thus increase overall flap survival. We believe from our prior experiments and results using hypertonic saline in a rat free flap model that this is the case. This experiment attempts to measure the improved microvascular blood flow by using Modulated Imaging (MI) Spectroscopy. We plan to do so by using MI spectroscopy to demonstrate the changes in total, oxygenated, and deoxygenated hemoglobin as well as the changes in water content within an ischemic flap after reperfusion when treated with hypertonic saline.