Document Detail


Blood flow in the foreign-body capsules surrounding surgically implanted subcutaneous devices.
MedLine Citation:
PMID:  19628222     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Surgically implanted devices initiate inflammatory mechanisms and wound healing events and result in the formation of a thick fibrotic capsule that surrounds the device. To investigate the foreign-body response to devices of clinically relevant size, we used microspheres to determine regional blood flow patterns in the foreign-body capsule (FBC) and surrounding subcutaneous tissue after device implantation.
MATERIALS AND METHODS: In 10 canines, we implanted 40 subcutaneous devices (polysulfone n = 20, silicone-coated n = 10, titanium n = 10). Via thoracotomy, animals were instrumented with left atrial and aortic vascular access catheters for serial microsphere injections and reference blood sampling. Regional blood flow was repeatedly determined in the FBC, subcutaneous fascia surrounding the FBC, and subcutaneous fascia distal to the surgical site up to 19 wk after device implantation (n = 55 determinations).
RESULTS: Compared with normal blood flow in subcutaneous fascia distal to the surgical site, blood flow increased in FBCs surrounding each device material (polysulfone P = 0.0035, silicone-coated P < 0.0001, titanium P < 0.0001). Additionally, blood flow increased in the subcutaneous fascia within half a centimeter of fibrous capsules encasing polysulfone (P = 0.0081) but not silicone (P = 0.3706) or titanium (P = 0.8160) devices. The time-course of measured blood flow changes within FBCs were similar for polysulfone and silicone but not for titanium.
CONCLUSIONS: Surgically implanted subcutaneous devices of clinically relevant size elicit increases in blood flow in the FBC as well as surrounding fascia. Device material may influence regional blood flow patterns.
Authors:
Carlo R Bartoli; John J Godleski
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The Journal of surgical research     Volume:  158     ISSN:  1095-8673     ISO Abbreviation:  J. Surg. Res.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-16     Completed Date:  2010-01-07     Revised Date:  2011-07-19    
Medline Journal Info:
Nlm Unique ID:  0376340     Medline TA:  J Surg Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  147-54     Citation Subset:  IM    
Affiliation:
Molecular and Integrative Physiological Sciences Program, Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA. crbart02@louisville.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Dogs
Female
Foreign Bodies / physiopathology*
Microspheres
Prostheses and Implants*
Regional Blood Flow
Subcutaneous Tissue / blood supply*
Grant Support
ID/Acronym/Agency:
ES00002/ES/NIEHS NIH HHS; R01 ES012972-01/ES/NIEHS NIH HHS; R01 ES012972-02/ES/NIEHS NIH HHS; R01 ES012972-03/ES/NIEHS NIH HHS; R01 ES012972-04/ES/NIEHS NIH HHS; R01 ES012972-05/ES/NIEHS NIH HHS; R01 ES12972/ES/NIEHS NIH HHS
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