The effects of cooling on experimental free flap survival

Remote ischemic perconditioning attenuates acute inflammation of experimental musculocutaneous flaps following ischemia‐reperfusion injury

“…30 It is well known that hypothermia prolongs the critical ischemia time of muscle and musculocutaneous flaps. 9,[31][32][33][34][35] However, the present study showed no protective effect of hypothermic ischemia on inflammatory cytokine secretion following ischemiareperfusion injury compared with normothermic ischemia. Hypothermic ischemia reduces flap ischemic tissue damage by lowering the metabolic rate, 11 but no parameters could elucidate this antiischemic effect of hypothermia in the present study.…”

“…8 The critical ischemia time varies according to the tissue type and storage temperature. 9,10 Cooling lowers the metabolism of tissues 11 and is routinely used for traumatic amputations. Furthermore, hypothermic flap ischemia has been applied in lower extremity trauma reconstruction where recipient vessel difficulties can lead to prolonged flap ischemia time.…”

Cryolipolysis for Noninvasive Fat Cell Destruction

“…In other situations, cold exposure can result in significant inflammation of the skin, [28][29][30] but fat appears to be more susceptible to cold exposure and to ischemia and ischemia-reperfusion injury than other tissues, including the skin. 25,31 Cryolipolysis relies on natural thermal diffusion to realize a gradual and tapered effect within the fat layer. Controlling the rate of energy extraction and duration of treatment may be used to limit the amount of tissue subject to Cryolipolysis according to treatment goals.…”

Cold storage of rat skeletal muscle free flaps and pre-ischemic perfusion with modified UW solution

“…Cold storage of tissues before microsurgical replantation is known to improve the survival of limbs, digits and myocutaneous flaps. [1][2][3][4][5] In complex limb replantations, myocutaneous tissue transfers involving lengthy ischemia times, and muscle flap transfers with secondary thrombosis, the relative susceptibility to ischemia of skin and muscle is important. 6 In some of these circumstances, the transferred or replanted part may fail to function fully because of necrosis of its muscle component.…”

“…6 Cooling to 6°C during ischemia increases the 50% survival time of skin to about 3-4 days. 2 In studies using rat cutaneous maximus muscle free flaps perfused ex vivo with heparinized citrate solution, Li and co-workers 8 found that a significant greater proportion of the muscle survived a combination of 4 h normothermic and 44 h hypothermic cold storage compared with nonperfused controls. Anticoagulated muscle sub-jected to relatively lengthy periods of ischemia was shown to still be viable after 2 weeks of reperfusion.…”