| Extracorporeal shock wave enhanced extended skin flap tissue survival via increase of topical blood perfusion and associated with suppression of tissue pro-inflammation. | |
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MedLine Citation:
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PMID: 17720194 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Distal skin flap ischemic necrosis is a significant challenge in reconstructive surgery. This study assessed whether extracorporeal shock wave (ESW) treatment rescues compromised flap tissue by enhancing tissue perfusion and is associated with suppression of inflammatory response. METHODS: This study used the dorsal skin random flap model in a rodent. Thirty-six male Sprague Dawley rats were divided into three groups. Group I, a control group, received no treatment. Group II was administrated 500 impulses of ESW treatment at 0.15 mJ/mm(2) as a single treatment immediately postoperatively. Group III received 500 impulses of ESW at 0.15 mJ/mm(2) applied immediately postoperatively and the day following surgery. Flap blood perfusion was detected by laser Doppler. Flap survival/necrosis area and histological staining of flap ischemia zone was performed on day 7 postoperatively. The tumor necrosis factor alpha, vascular endothelial growth factor, and proliferating cell nuclear antigen expression were evaluated with immunohistochemical staining. RESULTS: Experimental results indicated that the necrotic area of the flaps in Group II was significantly reduced compared with that in the control group (13 +/- 2.6% versus 42 +/- 5.7%, P < 0.01). There was small and insignificant reduction in the necrotic area in Group III compared with the controls. Flap tissue blood perfusion was significantly increased postoperatively in Group II. Histological staining indicated that ESW treatment substantially increased vascular endothelial growth factor and proliferating cell nuclear antigen expressions, reduced leukocyte infiltration, and suppression of tumor necrosis factor alpha expression in flap tissue ischemic zones in Group II compared with that in controls. CONCLUSION: Optimal dosage of ESW treatment has a positive effect in rescuing ischemic zone of flap by increasing tissue perfusion and is associated with suppressing inflammatory response. |
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Authors:
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Yur-Ren Kuo; Wen-Sheng Wu; Yu-Ling Hsieh; Feng-Sheng Wang; Chun-Ting Wang; Yuan-Cheng Chiang; Ching-Jen Wang |
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Publication Detail:
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Type: Journal Article Date: 2007-08-27 |
Journal Detail:
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Title: The Journal of surgical research Volume: 143 ISSN: 0022-4804 ISO Abbreviation: J. Surg. Res. Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2007-11-20 Completed Date: 2008-01-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376340 Medline TA: J Surg Res Country: United States |
Other Details:
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Languages: eng Pagination: 385-92 Citation Subset: IM |
Affiliation:
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Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan. t1207816@ms22.hinet.net |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Dermatitis / immunology, pathology, prevention & control High-Energy Shock Waves / therapeutic use* Ischemia / immunology, pathology, therapy* Male Necrosis Postoperative Complications / immunology, pathology, prevention & control* Rats Rats, Sprague-Dawley Regional Blood Flow Skin / blood supply, immunology, pathology Surgical Flaps / blood supply*, immunology*, pathology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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