Dermal microvasculature and tissue selective thinning techniques (ultrasound and water-jet) of short-time expanded skin in dogs

Abstract

Certain reconstructive procedures, like auricular reconstructions, require thin and well-vascularized skin. The aims of this study were to analyze if the increased survival of expanded skin flaps was due to morphologic changes of the dermis, if thinning of short-time expanded skin was possible without harm to the microcirculation and if tissue selective cutting methods could be used to resect subcutaneous fat without damaging its vessels. Eighty-two 200-ml expanders were implanted into the trunk regions of 26 beagles and filled immediately with sterile saline. In the first series of experiments, the expansion was terminated after intervals of 0.5-5 weeks and dermal vessels were analyzed morphometrically. In the second series the expanded flaps were raised after 2 weeks and thinned solely surgically or with the additional use of an ultrasonic knife or with cutting by water jet. In contrast to sham flaps, the expanded skin showed only very few areas of necrosis and these were located superficially in most cases. The relative volume of the dermal vessels and their quantity showed a significant increase after the expansion. Additionally, the subcutaneous tissue could be thinned down to 0.4 mm with the water-jet-cutter. Findings demonstrated that the method used could create a well-vascularized skin flap of minimal thickness that could be very helpful for special reconstructive procedures.

Histomorphologic findings in the facial nerve after water-jet dissection of the parotid gland in dogs

“…Erste Untersuchungen zum möglichen Einsatz des Wasserstrahldissektors bei der Parotischirurgie sind bereits durchgeführt worden. In einer vorangegangenen Studie wurde der Hydrojet zur Ohrspeicheldrüsenchirurgie am Tiermodell Hund erprobt [16,21]. Die hierbei gewonnenen Nervenäste dienten als Untersuchungsmaterial für die vorliegende Arbeit.…”

Animal Models for Experimental Neurosurgery of Peripheral and Cranial Nerves

“…Nowadays it is generally accepted in this surgical discipline [ 23 -27 ]. In the following years, waterjet dissection has been investigated in further surgical disciplines such as laparoscopic cholecystectomy [ 28 ], kidney [ 29 -31 ], vascular [ 32 ], or ophthalmologic [ 33 , 34 ] and dermatologic surgery [ 35 ].…”

Optimizing the Parameters for Hydro-Jet Dissection in Fatty Tissue - A Morphological Ex Vivo Analysis

“…Indeed, a significant temperature rise can be observed, resulting in a degradation of protein and nerve damage. Even blood vessels can be injured (7,8,12,14,15,23,24,25).…”

“…First clinical experience was made in reconstructive surgery. It is used experimentally for the thinning of skin flaps, leaving the subderreal vasculature intact (1,2,4,5,6,9,10,17,18,19,20,22,24,25,27). Additionally, the preparation of flap pedicles could be of interest for plastic surgeons.…”