Machine Perfusion Deters Ischemia-Related Derangement of a Rodent Free Flap: Development of a Model
Machine perfusion can enable isolated support of composite tissues, such as free flaps. The goal of perfusion in this setting is to preserve tissues prior to transplantation or provide transient support at the wound bed. This study aimed to establish a rodent model of machine perfusion in a fasciocu...
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| Veröffentlicht in: | The Journal of surgical research 2024-03, Vol.295, p.203-213 |
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| container_title | The Journal of surgical research |
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| creator | Orizondo, Ryan A. Bengur, Fuat Baris Komatsu, Chiaki Strong, Kelly R. Federspiel, William J. Solari, Mario G. |
| description | Machine perfusion can enable isolated support of composite tissues, such as free flaps. The goal of perfusion in this setting is to preserve tissues prior to transplantation or provide transient support at the wound bed. This study aimed to establish a rodent model of machine perfusion in a fasciocutaneous-free flap to serve as an affordable testbed and determine the potential of the developed support protocol to deter ischemia-related metabolic derangement.
Rat epigastric-free flaps were harvested and transferred to a closed circuit that provides circulatory and respiratory support. Whole rat blood was recirculated for 8 h, while adjusting the flow rate to maintain arterial-like perfusion pressures. Blood samples were collected during support. Extracellular tissue lactate and glucose levels were characterized with a microdialysis probe and compared with warm ischemic, cold ischemic, and anastomosed-free flap controls.
Maintenance of physiologic arterial pressures (85-100 mmHg) resulted in average pump flow rates of 360–430 μL/min. Blood-based measurements showed maintained glucose and oxygen consumption throughout machine perfusion. Average normalized lactate to glucose ratio for the perfused flaps was 5-32-fold lower than that for the warm ischemic flap controls during hours 2-8 (P |
| doi_str_mv | 10.1016/j.jss.2023.10.014 |
| format | Article |
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Rat epigastric-free flaps were harvested and transferred to a closed circuit that provides circulatory and respiratory support. Whole rat blood was recirculated for 8 h, while adjusting the flow rate to maintain arterial-like perfusion pressures. Blood samples were collected during support. Extracellular tissue lactate and glucose levels were characterized with a microdialysis probe and compared with warm ischemic, cold ischemic, and anastomosed-free flap controls.
Maintenance of physiologic arterial pressures (85-100 mmHg) resulted in average pump flow rates of 360–430 μL/min. Blood-based measurements showed maintained glucose and oxygen consumption throughout machine perfusion. Average normalized lactate to glucose ratio for the perfused flaps was 5-32-fold lower than that for the warm ischemic flap controls during hours 2-8 (P < 0.05).
We developed a rat model of ex vivo machine perfusion of a fasciocutaneous-free flap with maintained stable flow and tissue metabolic activity for 8 h. This model can be used to assess critical elements of support in this setting as well as explore other novel therapies and technologies to improve free tissue transfer.</description><identifier>ISSN: 0022-4804</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2023.10.014</identifier><identifier>PMID: 38035871</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Animals ; Extracorporeal perfusion system ; Ex vivo perfusion ; Fasciocutaneous free flap ; Free Tissue Flaps ; Glucose ; Ischemia - etiology ; Lactates ; Machine perfusion ; Perfusion - methods ; Rats ; Reconstructive microsurgery ; Rodentia</subject><ispartof>The Journal of surgical research, 2024-03, Vol.295, p.203-213</ispartof><rights>2023 Elsevier Inc.</rights><rights>Copyright © 2023 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c305t-87bb0f03c966a46c011498e67cf7f1de82f2df113112891e2d5e7955415ea09f3</cites><orcidid>0000-0002-6036-3458</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jss.2023.10.014$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38035871$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Orizondo, Ryan A.</creatorcontrib><creatorcontrib>Bengur, Fuat Baris</creatorcontrib><creatorcontrib>Komatsu, Chiaki</creatorcontrib><creatorcontrib>Strong, Kelly R.</creatorcontrib><creatorcontrib>Federspiel, William J.</creatorcontrib><creatorcontrib>Solari, Mario G.</creatorcontrib><title>Machine Perfusion Deters Ischemia-Related Derangement of a Rodent Free Flap: Development of a Model</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description>Machine perfusion can enable isolated support of composite tissues, such as free flaps. The goal of perfusion in this setting is to preserve tissues prior to transplantation or provide transient support at the wound bed. This study aimed to establish a rodent model of machine perfusion in a fasciocutaneous-free flap to serve as an affordable testbed and determine the potential of the developed support protocol to deter ischemia-related metabolic derangement.
Rat epigastric-free flaps were harvested and transferred to a closed circuit that provides circulatory and respiratory support. Whole rat blood was recirculated for 8 h, while adjusting the flow rate to maintain arterial-like perfusion pressures. Blood samples were collected during support. Extracellular tissue lactate and glucose levels were characterized with a microdialysis probe and compared with warm ischemic, cold ischemic, and anastomosed-free flap controls.
Maintenance of physiologic arterial pressures (85-100 mmHg) resulted in average pump flow rates of 360–430 μL/min. Blood-based measurements showed maintained glucose and oxygen consumption throughout machine perfusion. Average normalized lactate to glucose ratio for the perfused flaps was 5-32-fold lower than that for the warm ischemic flap controls during hours 2-8 (P < 0.05).
We developed a rat model of ex vivo machine perfusion of a fasciocutaneous-free flap with maintained stable flow and tissue metabolic activity for 8 h. This model can be used to assess critical elements of support in this setting as well as explore other novel therapies and technologies to improve free tissue transfer.</description><subject>Animals</subject><subject>Extracorporeal perfusion system</subject><subject>Ex vivo perfusion</subject><subject>Fasciocutaneous free flap</subject><subject>Free Tissue Flaps</subject><subject>Glucose</subject><subject>Ischemia - etiology</subject><subject>Lactates</subject><subject>Machine perfusion</subject><subject>Perfusion - methods</subject><subject>Rats</subject><subject>Reconstructive microsurgery</subject><subject>Rodentia</subject><issn>0022-4804</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LAzEQhoMoWj9-gBfZo5etM5v9yOpJqtWCRSl6Dml2oin7UZNtwX9vSqvePCUzPO8L8zB2jjBEwPxqMVx4P0wg4WEeAqZ7bIBQZrHIC77PBgBJEqcC0iN27P0CwlwW_JAdcQE8EwUOmJ4q_WFbil7ImZW3XRvdUU_ORxOvP6ixKp5RrXqqwt6p9p0aavuoM5GKZl21-Y8dUTSu1fI6IGuqu-UfMg1IfcoOjKo9ne3eE_Y2vn8dPcZPzw-T0e1TrDlkfSyK-RwMcF3muUpzDYhpKSgvtCkMViQSk1QGkSMmokRKqoyKMstSzEhBafgJu9z2Ll33uSLfy8Z6TXWtWupWXoZULhCyAgKKW1S7zntHRi6dbZT7kghy41YuZHArN243q-A2ZC529at5Q9Vv4kdmAG62AIUj15ac9NpSq6myjnQvq87-U_8NIvGImg</recordid><startdate>202403</startdate><enddate>202403</enddate><creator>Orizondo, Ryan A.</creator><creator>Bengur, Fuat Baris</creator><creator>Komatsu, Chiaki</creator><creator>Strong, Kelly R.</creator><creator>Federspiel, William J.</creator><creator>Solari, Mario G.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6036-3458</orcidid></search><sort><creationdate>202403</creationdate><title>Machine Perfusion Deters Ischemia-Related Derangement of a Rodent Free Flap: Development of a Model</title><author>Orizondo, Ryan A. ; Bengur, Fuat Baris ; Komatsu, Chiaki ; Strong, Kelly R. ; Federspiel, William J. ; Solari, Mario G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c305t-87bb0f03c966a46c011498e67cf7f1de82f2df113112891e2d5e7955415ea09f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Animals</topic><topic>Extracorporeal perfusion system</topic><topic>Ex vivo perfusion</topic><topic>Fasciocutaneous free flap</topic><topic>Free Tissue Flaps</topic><topic>Glucose</topic><topic>Ischemia - etiology</topic><topic>Lactates</topic><topic>Machine perfusion</topic><topic>Perfusion - methods</topic><topic>Rats</topic><topic>Reconstructive microsurgery</topic><topic>Rodentia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Orizondo, Ryan A.</creatorcontrib><creatorcontrib>Bengur, Fuat Baris</creatorcontrib><creatorcontrib>Komatsu, Chiaki</creatorcontrib><creatorcontrib>Strong, Kelly R.</creatorcontrib><creatorcontrib>Federspiel, William J.</creatorcontrib><creatorcontrib>Solari, Mario G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Orizondo, Ryan A.</au><au>Bengur, Fuat Baris</au><au>Komatsu, Chiaki</au><au>Strong, Kelly R.</au><au>Federspiel, William J.</au><au>Solari, Mario G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Machine Perfusion Deters Ischemia-Related Derangement of a Rodent Free Flap: Development of a Model</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2024-03</date><risdate>2024</risdate><volume>295</volume><spage>203</spage><epage>213</epage><pages>203-213</pages><issn>0022-4804</issn><eissn>1095-8673</eissn><abstract>Machine perfusion can enable isolated support of composite tissues, such as free flaps. The goal of perfusion in this setting is to preserve tissues prior to transplantation or provide transient support at the wound bed. This study aimed to establish a rodent model of machine perfusion in a fasciocutaneous-free flap to serve as an affordable testbed and determine the potential of the developed support protocol to deter ischemia-related metabolic derangement.
Rat epigastric-free flaps were harvested and transferred to a closed circuit that provides circulatory and respiratory support. Whole rat blood was recirculated for 8 h, while adjusting the flow rate to maintain arterial-like perfusion pressures. Blood samples were collected during support. Extracellular tissue lactate and glucose levels were characterized with a microdialysis probe and compared with warm ischemic, cold ischemic, and anastomosed-free flap controls.
Maintenance of physiologic arterial pressures (85-100 mmHg) resulted in average pump flow rates of 360–430 μL/min. Blood-based measurements showed maintained glucose and oxygen consumption throughout machine perfusion. Average normalized lactate to glucose ratio for the perfused flaps was 5-32-fold lower than that for the warm ischemic flap controls during hours 2-8 (P < 0.05).
We developed a rat model of ex vivo machine perfusion of a fasciocutaneous-free flap with maintained stable flow and tissue metabolic activity for 8 h. This model can be used to assess critical elements of support in this setting as well as explore other novel therapies and technologies to improve free tissue transfer.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38035871</pmid><doi>10.1016/j.jss.2023.10.014</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-6036-3458</orcidid></addata></record> |
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| language | eng |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Animals Extracorporeal perfusion system Ex vivo perfusion Fasciocutaneous free flap Free Tissue Flaps Glucose Ischemia - etiology Lactates Machine perfusion Perfusion - methods Rats Reconstructive microsurgery Rodentia |
| title | Machine Perfusion Deters Ischemia-Related Derangement of a Rodent Free Flap: Development of a Model |
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