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Towards Optimizing Sub-Normothermic Machine Perfusion in Fasciocutaneous Flaps: A Large Animal Study.

Authors :
Berkane, Yanis
Lellouch, Alexandre G.
Goudot, Guillaume
Shamlou, Austin
Filz von Reiterdank, Irina
Goutard, Marion
Tawa, Pierre
Girard, Paul
Bertheuil, Nicolas
Uygun, Basak E.
Randolph, Mark A.
Duisit, Jérôme
Cetrulo Jr., Curtis L.
Uygun, Korkut
Source :
Bioengineering (Basel). Dec2023, Vol. 10 Issue 12, p1415. 16p.
Publication Year :
2023

Abstract

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. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
23065354
Volume :
10
Issue :
12
Database :
Academic Search Index
Journal :
Bioengineering (Basel)
Publication Type :
Academic Journal
Accession number :
174400339
Full Text :
https://doi.org/10.3390/bioengineering10121415