The Effects of the Perfusion of Various Solutions on the No-Reflow Phenomenon in Experimental Free Flaps

Chait, Laurence A.; May, James R.; O’Brien, Barbara C.; Hurley, James C.

doi:10.1097/00006534-197803000-00017

Cited by 78 publications

(33 citation statements)

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“…The existence of this phenomenon was confirmed in a variety of animal models of brain ischemia. [3][4][5][6] It was also shown in a variety of other organs, including skin, 7,8 skeletal muscle, 9 and the kidney. 10 -12 Kloner et al 13 sought to find out whether the no-reflow phenomenon would be observed in ischemic canine hearts and whether it was related to microvascular damage.…”

Section: Historical Perspectivementioning

confidence: 99%

No-Reflow Phenomenon

2002

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Section: Historical Perspectivementioning

confidence: 99%

No-Reflow Phenomenon

2002

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“…While many investigators have re¬ ported some improvements in flap survival using different perfusates, 10,12,14,15,20,21,2' 5,27,31,34,87,38,41 others have found such pharmacologie interven¬ tions either deleterious3"411 or ineffec¬ tive. 5,8,16,23,42 In our study we have developed an experimental model to investigate the role of pharmacologie agents in pro¬ longing the primary and secondary critical ischemia times of experimental skin flaps. Since the secondary isch¬ emia time is the clinically relevant window of intervention in flap salvage procedures, determination of a poten¬ tial benefit in using the pharmacologie agents for the salvage of the failing flap will undoubtedly add an effective modality to the armamentarium of mi¬ crovascular surgeons in their quest for a 100% success rate in clinical free-flap surgery.…”

Section: Resultsmentioning

confidence: 99%

Temporal Factors Affecting the Secondary Critical Ischemia of Normothermic Experimental Skin Flaps

Babajanian

Zhang²,

Turk³

et al. 1991

Archives of Otolaryngology - Head and Neck Surgery

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“…[5][6][7] Recent studies have shown that perfusion with anticoagulated whole blood may offer a protective effect toward preventing ischemia/reperfusion injury. 1,8.9 More sophisticated approaches in designing the washout solution or incorporating beneficial agents have also yielded success.…”

Section: Discussionmentioning

confidence: 99%

Brief ex vivo perfusion with heparinized and/or citrated whole blood enhances tolerance of free muscle flaps to prolonged ischemia

Fowler

Cooley

1999

Microsurgery

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This study investigated the use of heparinized and/or citrated whole blood as a perfusate for enhancing muscle tolerance to warm ischemia. Unilateral cutaneous trunci muscle flaps were harvested from Sprague-Dawley rats and stored for 10 hr at 22-24 degrees C prior to transplantation to the groin. One group served as a non-perfused control. In three experimental groups, the flaps were hand-perfused ex vivo with 1.0 ml of heparinized, citrated, or heparinized and citrated autogenous whole blood at physiological pressures. Perfusion was administered over a 10-min period 5 hr into the ischemic period. Flaps were revascularized on the femoral vessels and then harvested 48 hr following revascularization. Tissue injury was assessed by calculation of flap weight change (indicator of tissue edema), histochemical evaluation of muscle dehydrogenase activity (nitroblue tetrazolium assay), and light microscopy. All perfused groups had significantly higher muscle dehydrogenase activity compared with non-perfused controls (P < 0.005). Perfusion with combined heparin-citrated blood was significantly more protective than perfusion with either anticoagulant alone (P < 0.025). The only statistically significant reduction in percent flap edema was seen in the combined heparin-citrate perfusion of flaps compared with nonperfused controls (P < 0.05). Histologic evaluation confirmed a reduction in tissue edema in the perfused flaps. We conclude that mid-ischemic perfusion with heparinized and/or citrated blood limits the deleterious effects of extended warm ischemia.

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The Effects of the Perfusion of Various Solutions on the No-Reflow Phenomenon in Experimental Free Flaps

Cited by 78 publications

References 0 publications

No-Reflow Phenomenon

No-Reflow Phenomenon

Temporal Factors Affecting the Secondary Critical Ischemia of Normothermic Experimental Skin Flaps

Brief ex vivo perfusion with heparinized and/or citrated whole blood enhances tolerance of free muscle flaps to prolonged ischemia

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