Extracorporeal perfusion of free muscle flaps in a porcine model using a miniaturized perfusion system

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Adrian Dragu - , University Medicine (Faculty of Medicine and University Hospital), University Center for Orthopedics, Trauma and Plastic Surgery, University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Torsten Birkholz - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Judith Amélie Kleinmann - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Stefan Schnürer - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Frank Münch - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Robert Cesnjevar - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Joachim Schmidt - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Christian Taeger - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Ulrich Kneser - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Raymund E. Horch - , Friedrich-Alexander University Erlangen-Nürnberg (Author)

Abstract

Introduction: The development of techniques in transplantation medicine-including various aspects-has made extraordinary progress within the past three decades. However, the transplantation of free tissue flaps with the common problem of limited ischemia time frames remains an area in which the understanding of mechanism during ischemia and reperfusion is still limited. Thus, similar to other organ transplantations, the prolongation of ischemic time and the possibility to perform an ex vivo perfusion is desirable. The purpose of this study was to create a closed and steady ex vivo perfusion system in order to analyze the possibility of using a miniaturized perfusion system for free muscle flaps that could also be clinically used for other solid organ transplantation. Materials and methods: The rectus abdominis muscles of six german pigs were used in the study. Each of these free muscle flaps was perfused for a period of 2 h using a pulsatile and closed pump perfusion system by cannulating the arterial and venous vessels of the flap pedicle. During the ex vivo perfusion parameters such as arterial and venous pressures were measured continuously. Results: A total of six ex vivo, closed and steady perfusions have been successfully performed. The optimal arterial flow rate of ex vivo perfusion of rectus abdominis muscle flaps was evaluated to be 10 ml/min. The constant measurement of arterial (46 ± 13 mmHg) and venous (-1 ± 1 mmHg) pressure in this ex vivo setting showed steady parameters during a period for up to 2 h. Conclusion: The data of this study indicate that the ex vivo perfusion of free muscle flaps is technically feasible and a closed and steady circulation is manageable for a period of up to 2 h.

Details

Original languageEnglish
Pages (from-to)849-855
Number of pages7
JournalArchives of orthopaedic and trauma surgery
Volume131
Issue number6
Publication statusPublished - Jun 2011
Peer-reviewedYes

External IDs

PubMed 21188393
ORCID /0000-0003-4633-2695/work/145698746

Keywords

Keywords

  • Ex vivo, Extracorporeal perfusion, Hypoxia, Ischemia, Muscle free flap, Porcine tissue, Reperfusion