Evaluation of clinically applicable exsanguination treatments to alleviate venous congestion in an animal skin flap model
Experimental study published in Wound Repair Regen (1999)
Abstract
This study compares the effectiveness of alleviating venous congestion with mechanically-made outlets or leech therapy in promoting skin flap survival. Free flaps of abdominal skin (3 x 6 cm) were raised on Sprague-Dawley rats and subjected to ischemic events, simulating venous congestion. Animals received 1) no treatment; 2) two treatments involving two 18-gauge needle-puncture outlets; or 3) two sessions of leech therapy. Flap perfusion was monitored with a scanning laser Doppler flowmeter. Photographic images of flaps at 7 days were assessed for areas of normal tissue (n = 15), and laser Doppler flowmeter data consisted of control (n = 6), outlet (n = 6), and leech (n = 7). Both the needle-puncture outlet (40.0% +/- 9.24%) and leech treated (34.6% +/- 7.34%) groups had a significantly greater surviving skin area than untreated control flaps (8.0% +/- 5.0%), with 2 of 15 flaps receiving mechanical outlets exhibiting > 90% surviving area. After 7 days, laser Doppler flowmeter data showed greater mean perfusion in the outlet (71.7% +/- 16.8%) and leech (92.6% +/- 17.2%) treated groups, compared to controls (15.2% +/- 10.2%). There was a significant increase in perfusion in the outlet (13.3% +/- 6.2%) and leech (9.1% +/- 1.1%) treated groups from the end of secondary ischemia to day 7 (p < 0.05) compared to controls. The results suggest that two spatially separated outlets are as effective as one leech in increasing the area of surviving skin in venous congested flaps.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
Two needle-puncture outlets and leech therapy each significantly improved skin flap survival versus controls (40% and 35% vs 8%) in venous congested rat skin flap model.
Warum dies für die Hirudotherapie relevant ist
Diese vergleichende Tierstudie verwendete ein Ratten-Hautlappen-Modell (3×6 cm abdominale Lappen), um Nadelpunktionsauslässe versus Blutegeltherapie bei venöser Stauung zu evaluieren. Beide Behandlungen verbesserten die 7-Tage-Überlebensfläche der Haut signifikant (Auslässe 40,0%, Blutegel 34,6%) im Vergleich zu unbehandelten Kontrollen (8,0%), und beide erhöhten die Perfusion gegenüber den Kontrollen. Die Autoren schlussfolgerten, dass zwei räumlich getrennte mechanische Auslässe ebenso wirksam waren wie ein einzelner Blutegel. Diese Studie ist für ASH direkt relevant, da sie präklinische Vergleichsdaten zur Wirksamkeit der Blutegeltherapie bei der Lappenrettung liefert. Jedoch handelt es sich um ein Tiermodell mit kleinen Stichprobengrößen (n=6–7 pro Gruppe für Perfusionsdaten), was die direkte klinische Translation einschränkt.
Zitation
Evaluation of clinically applicable exsanguination treatments to alleviate venous congestion in an animal skin flap model.
Cottler PS et al. · Wound repair and regeneration, 1999
Verwandter klinischer Kontext
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