Injection of SVF combined with HBO2 improves viability of unfavorably designed flaps
| Autor: | Ian Grover, Mayer Tenenhaus, Sandra Hayes, Philippe Foubert, Nicole Ann Gaid |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Necrosis medicine.medical_treatment Guinea Pigs Ischemia Apoptosis Surgical Flaps Random Allocation 03 medical and health sciences Hyperbaric oxygen Adipocytes In Situ Nick-End Labeling medicine Animals Flap survival Saline Hyperbaric Oxygenation business.industry Graft Survival General Medicine Stromal vascular fraction medicine.disease Combined Modality Therapy Surgery 030104 developmental biology Adipose Tissue Blood Vessels Female medicine.symptom Stem cell business Reperfusion injury Stem Cell Transplantation |
| Zdroj: | Undersea and Hyperbaric Medicine. 45:381-388 |
| ISSN: | 1066-2936 |
| DOI: | 10.22462/07.08.2018.1 |
| Popis: | Purpose: Soft-tissue reconstruction is complicated by ischemia and reperfusion injury. Animal trials have documented the independent healing benefits of hyperbaric oxygen preconditioning (HBOP) and stem cell delivery in cutaneous flaps. We explored the role of HBOP and stem cell delivery in flap preconditioning and survival. Methods: We designed a randomized controlled trial to assess the effects of hyperbaric oxygen preconditioning and stromal vascular fraction (SVF) delivery on flap survival. Of the first 24 guinea pigs, six received neither HBOP nor injections, and six underwent HBOP without injections. Of the remaining 12 animals, six received SVF or saline injections in the absence of HBOP. The final six animals received autologous SVF injections or saline injections followed by four HBOP treatments. To enhance clinical relevance, a group of 6 animals underwent HBOP prior to SVF or saline injections. Thereafter, an unfavorably designed cutaneous flap was elevated and assessed via study-blinded observer, as well as by quantification of TUNEL-positive cells. Results: Distal necrosis of the tissue flap was more ex- tensive in the no-intervention group (45% of flap). Flaps treated with HBOP only and those treated with SVF injections demonstrated only 38.2% and 27.1% distal necrosis. The most significant difference occurred in the combination HBOP and SVF group, where distal necrosis was only 21.1% of the flap (p ≤ 0.05). SVF delivery immediately prior to flap elevation further minimized distal necrosis of the flap to 15.6%. These findings were mirrored by the TUNEL assay. Conclusions: Combining HBOP and SVF improves flap viability. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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