Negative pressure wound therapy reduces the ischaemia/reperfusion-associated inflammatory response in free muscle flaps

Eisenhardt, Steffen U.; Schmidt, Yvonne; Thiele, Jan; Iblher, Niklas; Penna, Vincenzo; Torio-Padron, Nestor; Stark, G. Björn; Bannasch, Holger

doi:10.1016/j.bjps.2011.11.037

Cited by 73 publications

(71 citation statements)

References 36 publications

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“…This tissue represent an attractive human surrogate tissue to investigate the mechanisms of IRI, as the tissue undergoes reproducible times of ischemia and is easily accessible for biopsies and further investigations without risk for the patient. This technique has already been used by us and others to investigate potential treatment concepts aimed to reduce IRI [7,8,46]. As these samples represent striated muscle tissue, care has to be taken when extrapolating results obtained in this tissue to the myocardium.…”

Section: Selection Of Mir-155 As Target Mirmentioning

confidence: 98%

“…IL-1b is a major contributing factor to IRI in the murine myocardium [44] and has been shown to directly correlate with the extent of IRI in human free muscle flaps [8].…”

Section: Regulation Of Inflammation By Mir-155mentioning

confidence: 99%

“…Biopsies were taken during the surgery before interruption of the blood supply to the flap and 5 days after surgery [7,8]. Samples for RNA extraction were stored in RNA-later (Qiagen, Hilden, Germany) for 24 h at 4°C and at -80°C until use [7].…”

Section: Patient Samples and Tissue Preparationmentioning

confidence: 99%

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MicroRNA-155 aggravates ischemia–reperfusion injury by modulation of inflammatory cell recruitment and the respiratory oxidative burst

Eisenhardt

Weiss

Smolka³

et al. 2015

Basic Res Cardiol

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The inflammatory sequelae of ischemia-reperfusion injury (IRI) are a major causal factor of tissue injury in various clinical settings. MicroRNAs (miRs) are short, non-coding RNAs, which regulate protein expression. Here, we investigated the role of miR-155 in IR-related tissue injury. Quantifying microRNA-expression levels in a human muscle tissue after IRI, we found miR-155 expression to be significantly increased and to correlate with the increased expression of TNF-α, IL-1β, CD105, and Caspase3 as well as with leukocyte infiltration. The direct miR-155 target gene SOCS-1 was downregulated. In a mouse model of myocardial infarction, temporary LAD ligation and reperfusion injury resulted in a smaller area of necrosis in miR-155-/- animals compared to wildtype animals. To investigate the underlying mechanisms, we evaluated the effect of miR-155 on inflammatory cell recruitment by intravital microscopy and on the generation of reactive oxygen species (ROS) of macrophages. Our intravital imaging results demonstrated a decreased recruitment of inflammatory cells in miR-155-/- animals during IRI. The generation of ROS in leukocytic cells of miR-155-/- animals was also reduced. RNA silencing of the direct miR-155 target gene SOCS-1 abrogated this effect. In conclusion, miR-155 aggravates the inflammatory response, leukocyte infiltration and tissue damage in IRI via modulation of SOCS-1-dependent generation of ROS. MiR-155 is thus a potential target for the treatment or prevention of IRI.

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Section: Selection Of Mir-155 As Target Mirmentioning

confidence: 98%

“…IL-1b is a major contributing factor to IRI in the murine myocardium [44] and has been shown to directly correlate with the extent of IRI in human free muscle flaps [8].…”

Section: Regulation Of Inflammation By Mir-155mentioning

confidence: 99%

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MicroRNA-155 aggravates ischemia–reperfusion injury by modulation of inflammatory cell recruitment and the respiratory oxidative burst

Eisenhardt

Weiss

Smolka³

et al. 2015

Basic Res Cardiol

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“…Possible explanations for the distal myocutaneous flap necrosis seen in this case include lack of proximal muscle excision as was recommended during the original study by Weinstein et al, excessive flap shear in lieu of lateral splint stabilization, or hindered blood flow due to the nature of segmental blood supply to the muscle [3]. The authors initially had concern that the VAC system may have impaired the local blood supply to the flap with excessive negative pressure and subsequent areas of hypoxia, but this is considered unlikely as a decrease in local ischemia and reperfusion injury to free muscle flaps in humans treated with adjunctive negative pressure treatment of 125 mmHg was reported [24]. Although this beneficial effect was not elicited in dogs, we believe that the pressure applied to the wound was potentially subtherapeutic because of the lower negative pressure setting in addition to an interface dressing, which also decreased the pressure delivered over the wound.…”

Section: Discussionmentioning

confidence: 99%

Vacuum-Assisted Closure Combined with a Myocutaneous Flap in the Management of Osteomyelitis in a Dog

Shomper

Coutin

Lanz

2013

Case Reports in Veterinary Medicine

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Case Description. A 2.5-year-old female spayed mixed breed dog presented to the Teaching Hospital for draining tracts on the left medial aspect of the tibia. Two years prior to presentation, the patient sustained a left tibial fracture, which was repaired with an intramedullary (IM) pin and two cerclage wires. Multiple antimicrobials were utilized during this time. Clinical Findings. Radiographs were consistent with left tibial osteomyelitis. The implant was removed and the wound was debrided. Treatment and Outcome. A bone window on the medial aspect of the tibia was created in order to facilitate implant removal. The wound and associated bone window were treated with vacuum assisted closure (VAC) in preparation for reconstructive surgery. Adjunctive VAC therapy was utilized following the caudal sartorius myocutaneous flap. Complications following this surgery included distal flap necrosis and donor site dehiscence. Clinical Relevance. This presents a difficult case of canine osteomyelitis with subsequent wound care in which VAC and a myocutaneous flap were useful adjunctive treatments for osteomyelitis. This is the first report of VAC in the management of canine osteomyelitis and management with a myocutaneous flap.

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“…Most studies [69][70][71] indicated favorable results with NPWT, presumably through improved perfusion and reduced edema and/or clearance of venous congestion. However, to our knowledge, no high-level evidence exists to support the use of NPWT with local or free flaps.…”

Section: Management Of Skin Grafts and Flapsmentioning

confidence: 94%

Negative-Pressure Wound Therapy in Acute Traumatic and Surgical Wounds in Orthopaedics

Harvin

Stannard

2014

JBJS Rev

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Negative pressure wound therapy reduces the ischaemia/reperfusion-associated inflammatory response in free muscle flaps

Cited by 73 publications

References 36 publications

MicroRNA-155 aggravates ischemia–reperfusion injury by modulation of inflammatory cell recruitment and the respiratory oxidative burst

MicroRNA-155 aggravates ischemia–reperfusion injury by modulation of inflammatory cell recruitment and the respiratory oxidative burst

Vacuum-Assisted Closure Combined with a Myocutaneous Flap in the Management of Osteomyelitis in a Dog

Negative-Pressure Wound Therapy in Acute Traumatic and Surgical Wounds in Orthopaedics

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