Extracorporal shock wave may enhance skin flap survival in an animal model

Meirer, Romed; Kamelger, Florian; Huemer, Georg M.; Wanner, S.; Piza‐Katzer, Hildegunde

doi:10.1016/j.bjps.2004.04.027

Cited by 53 publications

(42 citation statements)

References 22 publications

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“…In a previous study, a significant increase of growth factors, such as endothelial nitric oxide synthase, VEGF, and PCNA, induced in-growth of neovascular formation [15][16][17]19]. Recently, Meirer et al indicated that ESW therapy has a rescue effect on extended skin epigastric artery island flaps in a rodent model [23,24]. However, the exact biological mechanism of shock wave therapy in ischemic flap tissue remains unknown.…”

Section: Discussionmentioning

confidence: 95%

“…The cascade of biological effects associated with ESW is directly correlated with enhanced blood supply and tissue regeneration. Recently, the effects of ESW therapy on skin flap tissue have been documented in a rat model, which showed that ESW enhances the distal area of the extended island skin flap survival [23,24]. However, the biomechanisms of ESW rescue of ischemic skin flap survival remain unknown.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Extracorporeal Shock Wave Enhanced Extended Skin Flap Tissue Survival via Increase of Topical Blood Perfusion and Associated with Suppression of Tissue Pro-Inflammation

Kuo

Hsieh

et al. 2007

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Extracorporeal Shock Wave Enhanced Extended Skin Flap Tissue Survival via Increase of Topical Blood Perfusion and Associated with Suppression of Tissue Pro-Inflammation

Kuo

Hsieh

et al. 2007

Journal of Surgical Research

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“…We have recently shown in a mouse model of severe full-thickness burn injury that ESWT has significant anti-inflammatory properties associated with a significant decrease in pro-inflammatory chemokine and cytokine synthesis at the wound site coupled with a marked reduction in inflammatory leukocyte recruitment to the treated burn [23]. Furthermore, preliminary findings from earlier studies suggest that local delivery of shock waves may stimulate early expression of angiogenesis-related growth factors including endothelial nitric oxide synthase (eNOS), vascular endothelial growth factor (VEGF), and proliferating cell nuclear antigen (PCNA), associated with vasculogenesis, improved local blood flow, EC proliferation, and accelerated soft tissue repair [24][25][26][27].…”

Section: Introductionmentioning

confidence: 97%

Angiogenic response to extracorporeal shock wave treatment in murine skin isografts

et al. 2008

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Skin grafts are commonly utilized and proven effective methods of open wound coverage. Revascularization through neoangiogenesis is a pivotal mechanism for skin graft integration and durability. Extracorporeal shock-wave treatment (ESWT) has been demonstrated to accelerate wound repair; however, its mechanism-of-action is unclear. We investigated the role of ESWT in early revascularization of full-thickness skin isografts in a murine model. Cohorts of mice were euthanized and skin grafts were harvested 6 h, 2, 4, and 7 days post grafting +/- ESWT. Various aspects of graft neovascularization were measured including gross morphology, quantitative microscopy (vessel number, density), immunohistochemistry (CD31), cDNA SuperArrays for 84 angiogenesis-specific genes, and custom-designed 'Wound Repair' TaqMan Low Density Array (TLDA) cards to assess expression of 188 wound repair genes. We demonstrate that a single administration of ESWT immediately following skin grafting significantly enhances recipient graft revascularization (increased vessel number, size, and density). An augmented early pro-angiogenic and suppressed delayed pro-inflammatory response to ESWT was accompanied by significantly increased expression of both skin graft CD31 and angiogenesis pathway-specific genes, including ELR-CXC chemokines (CXCL1, CXCL2, CXCL5), CC chemokines (CCL2, CCL3, CCL4), cytokines (IL-1 beta, IL-6, G-CSF, VEGF-A), matrix metalloproteinases (MMP3, MMP9, MMP13), hypoxia-inducible factors (HIF-1 alpha), and vascular remodeling kinase (Mst1), as early as 6 h and up to 7 days post grafting and treatment. These findings suggest that early pro-angiogenic and anti-inflammatory effects of ESWT promote tissue revascularization and wound healing by augmenting angiogenesis and dampening inflammation.

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“…The effect of ESWA on angiogenesis and inflammation seems to be essential for the enhanced results in skin flap tissue survival. Meirer et al 1 used a skin flap model with sprague-dawley rats to show that shock waves can enhance skin flap survival after surgery. Up to now, there is no consensus on the type of wounds most likely to benefit from shock waves and also on which shock wave parameters are best, regarding energy, degree of focus and frequency or number of cycles.…”

Section: Introductionmentioning

confidence: 99%

Effects of low-dose extracorporeal shock waves on microcirculation

Khaled¹,

Goertz²,

Lauer³

et al. 2012

AIP Conference Proceedings

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Abstract. The extended wounds of burn patients remain a challenge due to wound infection and following septicemia. The aim of this study was to analyze microcirculation, angiogenesis and leukocyte endothelium interaction after burn injury with and without extracorporeal shock wave application (ESWA). A novel shockwave system was developed based on a commercially available device for orthopedics (Dornier Aries®) that was equipped with a newly developed applicator. This system is based on the electromagnetic shock wave emitter (EMSE) technology and was introduced to accomplish a localized treatment for wound healing. The system includes a novel field of focus for new applications, with high precision and ease of use. In the animal study, full-thickness burns were inflicted on to the ears of hairless mice (n=51). Intravital fluorescent microscopy was used to assess microcirculatory parameters, angiogenesis and leukocyte behavior. ESWA was performed on day 1, 3 and 7. Values were obtained immediately after burn, as well as at days 1, 3, 7, and 12 post burn. All shockwave treated groups showed an accelerated angiogenesis with a less non-perfused area and an improved blood flow after burn injury compared to the placebo control group. After three treatments, the shock waves increased the number of rolling leukocytes significantly compared to the non-treated animals. Shock waves seem to have a positive effect on several parameters of wound healing after burn injury. However, further investigations are necessary to detect positive influence of shock waves on microcirculation after burn injuries.

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Extracorporal shock wave may enhance skin flap survival in an animal model

Cited by 53 publications

References 22 publications

Extracorporeal Shock Wave Enhanced Extended Skin Flap Tissue Survival via Increase of Topical Blood Perfusion and Associated with Suppression of Tissue Pro-Inflammation

Extracorporeal Shock Wave Enhanced Extended Skin Flap Tissue Survival via Increase of Topical Blood Perfusion and Associated with Suppression of Tissue Pro-Inflammation

Angiogenic response to extracorporeal shock wave treatment in murine skin isografts

Effects of low-dose extracorporeal shock waves on microcirculation

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