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Villegas-Alzate F, Caycedo-García DJ, Malaver-Acero R, Hidalgo-Ibarra SA, Cardona VA, Villegas-Mesa JD. TULUA: Effects of Flap Undermining and Type of Wall Plicature in a Rat Model Abdominoplasty. Aesthetic Plast Surg 2022; 46:456-467. [PMID: 34424368 DOI: 10.1007/s00266-021-02501-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/22/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND TULUA, a transverse plication lipoabdominoplasty, which excludes elevation of the supraumbilical flap and includes a skin graft neoumbilicoplasty, claims greater safety and better results. An animal study was designed to compare it, with two current techniques. MATERIALS AND METHODS Three matched groups of 12 rats had combined liposuction and abdominoplasty. Liposuction was extensive and unrestricted. Groups 1 and 2 had vertical plication and transposition umbilicoplasty, and group 3 had transverse plication and neoumbilicoplasty. Flap elevation in the epigastrium was wide to costal margins in group 1, limited to a tunnel in group 2, and no dissection in group 3. The animals were observed for 21 days and then euthanized. Intraoperative, postoperative, and postmortem variables and findings were measured and analyzed to find differences between groups. RESULTS Transverse lipoabdominoplasty demonstrated a wider wall plication area, as well as a decrease in tension to close the wound, causing the horizontal scar to remain in a low position. In vertical plication lipoabdominoplasty groups, flap necrosis and seromas were more frequent, and the umbilical position descended due to secondary healing and scar contraction. The scar's scores were better in the transverse group and were confirmed when evaluated by external observers.In postmortem examination, horizontal plication presented less widening; perforator vessels were preserved when surgical undermining of the upper abdomen was not performed, and there were fewer seromas. CONCLUSION In a rat model, TULUA demonstrates superior results and a decrease in complications when compared to lipoabdominoplasties with vertical plication and wide or tunneled dissection in the upper abdomen. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Francisco Villegas-Alzate
- Departamento de cirugía plástica, Facultad de Salud, Universidad del Valle, Calle 4B N°36-00, Cali, Colombia.
| | - Diego José Caycedo-García
- Jefe de servicio de cirugía plástica, Universidad del Valle, 3 piso hospital universitario del Valle, Cali, Colombia
| | - Ricardo Malaver-Acero
- Facultad de medicina veterinaria y zootecnia, Universidad San Martin Cali Colombia, Carrera 122 #23-395 del, Vía Cali - Puerto Tejada, Cali, Cauca, Colombia
| | | | | | - José Daniel Villegas-Mesa
- Escuela de Ciencias de la Salud, Universidad Pontificia Bolivariana, Calle 78b No 72a-109, Medellín, Colombia
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Cold Atmospheric Plasma, Platelet-Rich Plasma, and Nitric Oxide Synthesis Inhibitor: Effects Investigation on an Experimental Model on Rats. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12020590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The evolution of reconstructive methods for defects of the human body cannot yet replace the use of flap surgery. Research is still preoccupied with the ideal techniques for offering the best chances of survival of the flaps. In our study, we investigated the effects of cold atmospheric plasma (CAP), N-nitro-L-arginine methyl ester (L-NAME), and platelet-rich plasma (PRP) injectable solutions on flap survival using an in vivo model. Twenty-four Wistar rats (four groups) had the McFarlane flap raised and CAP, L-NAME, and PRP substances tested through a single dose subcutaneous injection. The control group had only a saline solution injected. To the best of our knowledge, this is the first study that evaluated a CAP activated solution through injection on flaps. The flap survival rate was determined by clinical examination (photography documented), hematology, thermography, and anatomopathological tests. The image digital analysis performed on the flaps showed that the necrosis area (control—49.64%) was significantly lower for the groups with the three investigated solutions: CAP (14.47%), L-NAME (18.2%), and PRP (23.85%). Thermography exploration revealed less ischemia than the control group on the CAP, L-NAME, and PRP groups as well. Anatomopathological data noted the best degree of angiogenesis on the CAP group, with similar findings on the L-NAME and PRP treated flaps. The blood work did not indicate infection or a strong inflammatory process in any of the subjects. Overall, the study shows that the CAP activated solution has a similar (better) impact on the necrosis rate (compared with other solutions with known effects) when injected on the modified dorsal rat skin flap, and on top of that it can be obtained fast, in unlimited quantities, non-invasively, and through a standardized process.
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He D, Li N, Lu X, Li W, Chen Y, Sun Z, Zhang L, Guo L, Cui X, Song G, Niu W, Zhang Q. Association of mitochondrial respiratory chain enzymes with the risk and mortality of sepsis among Chinese children. BMC Infect Dis 2022; 22:34. [PMID: 34991517 PMCID: PMC8740061 DOI: 10.1186/s12879-021-07014-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sepsis is a leading cause of pediatric morbidity and mortality worldwide. The aim of this study was to explore the association of decreased mitochondrial respiratory chain enzyme activities with the risk for pediatric sepsis, and explore their association with mortality among affected children. METHODS A total of 50 incident cases with sepsis and 49 healthy controls participated in this study. The level of serum coenzyme Q10 was measured by high-performance liquid chromatography, and selected mitochondrial respiratory chain enzymes in WBC were measured using spectrophotometric. Logistic regression models were used to estimate odds ratio (OR) and 95% confidence interval (CI). RESULTS The levels of CoQ10, complex II, complex I + III and FoF1-ATPase were significantly higher in healthy controls than in children with sepsis (p < 0.001, = 0.004, < 0.001 and < 0.001, respectively). In children with sepsis, levels of CoQ10 and complex I + III were significantly higher in survived cases than in deceased cases (p < 0.001). Per 0.05 μmol/L, 50 nmol/min.mg and 100 nmol/min.mg increment in CoQ10, complex I + III and FoF1-ATPase were associated with significantly lowered risk of having sepsis, even after adjusting for confounding factors (OR = 0.85, 0.68 and 0.04, p = 0.001, < 0.001 and < 0.001, respectively). Per 0.05 μmol/L and 50 nmol/min.mg increment in CoQ10 and complex I + III was associated with significantly lowered risk of dying from sepsis during hospitalization, and significance retained after adjustment (OR = 0.73 and 0.76, 95% CI: 0.59 to 0.90 and 0.64 to 0.89, p = 0.004 and 0.001, respectively) in children with sepsis. CONCLUSIONS Our findings indicate the promising predictive contribution of low serum CoQ10 and complex I + III to the risk of pediatric sepsis and its associated mortality during hospitalization among Chinese children. Trial registration The trial was registered with www.chictr.org.cn , number ChiCTR-IOR-15006446 on May 05, 2015. Retrospectively registered.
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Affiliation(s)
- Danni He
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, No. 2 Yinghua East Street, Chaoyang District, Beijing, 100029, China.,Department of Pediatrics, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, China
| | - Ning Li
- Intensive Care Unit, Affiliated Children's Hospital of Capital Institute of Pediatrics, Beijing, China
| | - Xiuxiu Lu
- Intensive Care Unit, Affiliated Children's Hospital of Capital Institute of Pediatrics, Beijing, China
| | - Wei Li
- Intensive Care Unit, Affiliated Children's Hospital of Capital Institute of Pediatrics, Beijing, China
| | - Yuanmei Chen
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, No. 2 Yinghua East Street, Chaoyang District, Beijing, 100029, China
| | - Zhongyuan Sun
- Intensive Care Unit, Affiliated Children's Hospital of Capital Institute of Pediatrics, Beijing, China
| | - Lipeng Zhang
- Department of Pediatrics, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, China.,Graduate School of Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Linying Guo
- Intensive Care Unit, Affiliated Children's Hospital of Capital Institute of Pediatrics, Beijing, China
| | - Xiaodai Cui
- Central Laboratory, Capital Institute of Pediatrics, Beijing, China
| | - Guowei Song
- Central Laboratory, Capital Institute of Pediatrics, Beijing, China
| | - Wenquan Niu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, No. 2 Yinghua East Street, Chaoyang District, Beijing, 100029, China.
| | - Qi Zhang
- Department of Pediatrics, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, China.
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Effectiveness of Different Surgical Flap Delay Methods and Their Systemic Toxicities. J Craniofac Surg 2021; 32:1946-1950. [PMID: 33464774 DOI: 10.1097/scs.0000000000007444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The surgical flap delaying has been shown to be effective in preventing partial flap loss or in preparing larger flaps. However, there is no gold standard flap delay method in the literature. In this study, the authors aimed to compare 3 types of surgical delay methods to determine which model would increase more flap survival. The authors also investigated the effect of delay methods on circulating mononuclear leukocytes as a parameter of DNA damage. METHODS Twenty-four Sprague-Dawley male rats were divided into 4 groups. All subjects had a 10 × 3 cm modified McFarlane flap. Surface area measurements, biopsies, and blood samples were taken on the day of sacrification; 7th day for the control group and 14th day for delay groups. RESULTS Between incisional surgery delay groups, a significant difference was found in necrosis and apoptosis in the bipedicled group, and only necrosis in the tripedicled group compared to the control. In terms of DNA damage, it was found higher in all experimental groups than in the control group. CONCLUSIONS Both incisional surgical delay procedures' results were meaningfully effective when only incisions were made without the elevation of flaps. In conclusion, bipedicled incisional surgical delay seems to be the most effective method in McFarlane experimental flap model whereas two-staged surgeries may increase the risk of systemic toxicity.
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Comparison of the efficacy of multiple antioxidant and hyperbaric oxygen treatments in the prevention of ischemia and necrosis of local random McFarlane skin flap. J Tissue Viability 2021; 30:196-206. [PMID: 33736935 DOI: 10.1016/j.jtv.2021.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 01/26/2021] [Accepted: 02/19/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of this study was to compare the efficacy of multiple antioxidant (Proxeed Plus (PP) with Carnitine, Selenium, Zinc, Coenzyme Q10, Vitamin C, Folic Acid, Vitamin B12) on local random skin flap healing with the hyperbaric oxygen (HBO) therapy. METHODS Fourty rats were equally divided into five groups (Control, PP, HBO, HBO + PP, PP + HBO + PP). Local random McFarlane skin flap was applied to all rats. Following the applications, evaluations were made biochemical (TAS, TOS, OSI, IL-1β, IL-6, TNF-α, TGF-β, VEGF) and histopathological parameters. RESULTS Necrosis percentage was found to be lower in the PP + HBO + PP group than all other groups whereas the necrosis percentages of PP and HBO groups were similar. Oxidative stress rates were significantly higher in the control group compared to the other groups whereas it was lower in the PP + HBO + PP group than all other groups. The inflammation parameters were the highest in the control group and the lowest in the PP + HBO + PP group. Growth factors were higher in the PP + HBO + PP group than all other groups. Epithelialization and wound healing were better in the HBO and PP groups than in the control group. The greatest healing, epithelialization and vascularization was seen in the PP + HBO + PP group. The histopathological findings in the PP + HBO + PP group were better in each inner region than in the other groups. CONCLUSION Biochemical and histopathological parameters have shown that PP reduces ischemia and necrosis and increases oxygenation in flap healing by providing significant improvement thanks to the multiple molecular structures in its content.
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Altınel D, Serin M, Erdem H, Biltekin B, Huseyinbas O, Toplu G, Kurt Yazar S. Comparison of incisional delay patterns on a rat random flap model. J Plast Surg Hand Surg 2019; 53:247-253. [PMID: 30929551 DOI: 10.1080/2000656x.2019.1588740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
One of the simplest form of surgical delay can be performed by placing an incision around the flap without undermining, prior to flap elevation. In this study, we have compared the efficiency of different patterns of skin incision to improve flap survival. Twenty-eight animals were used in four groups. Incisional delay was performed prior to flap elevation in the three experiment groups. Complete incision of the three flap edges was performed in the all experiment groups with the exception of an intact skin section on the middle 1/3rd of the bilateral edges in group 1 (bilateral skin edge preserved delay: BSEPD), of a unilateral edge in group 2 (unilateral skin edge preserved delay: USEPD) and of the superior edge in group 3 (superior skin edge preserved delay: SSEPD) without any undermining. Two weeks following the delay procedure, dorsal skin flaps were raised and reinserted back to their place. The results were evaluated with the measurement of necrotic flap area, microangiographic imaging and histological evaluation. The mean percentage of necrotic flap area to whole flap area was 16.94%, 7.54%, 23.34% and 50.6% in the BSEPD, USEPD, SSEPD and control groups, respectively. In selected microangiographic images, vessels were more prominent in the delay groups. The results of the study indicate that three sided incision with an intact skin on the superior edge is not effective in providing a sufficient delay and flap survival improvement when compared to incisions with intact skin on the unilateral and bilateral edges.
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Affiliation(s)
- Dincer Altınel
- a Department of Plastic and Reconstructive Surgery, University of Health Sciences, Istanbul Training and Research Hospital , Istanbul , Turkey
| | - Merdan Serin
- a Department of Plastic and Reconstructive Surgery, University of Health Sciences, Istanbul Training and Research Hospital , Istanbul , Turkey
| | - Havva Erdem
- b Department of Pathology, Ordu University Training and Research Hospital , Ordu , Turkey
| | - Burcu Biltekin
- c Department of Histology and Embryology, Istanbul University, Cerrahpasa Medical School , Istanbul , Turkey
| | - Onder Huseyinbas
- d Animal Research Laboratory, Bezmialem University Medical School , Istanbul , Turkey
| | - Gaye Toplu
- a Department of Plastic and Reconstructive Surgery, University of Health Sciences, Istanbul Training and Research Hospital , Istanbul , Turkey
| | - Sevgi Kurt Yazar
- a Department of Plastic and Reconstructive Surgery, University of Health Sciences, Istanbul Training and Research Hospital , Istanbul , Turkey
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Nutritional and Pharmacological Effects on Oxidative Stress in Soft Tissue and Bone Remodeling. J Nutr Metab 2018; 2018:4183407. [PMID: 30687551 PMCID: PMC6327261 DOI: 10.1155/2018/4183407] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 11/05/2018] [Accepted: 12/09/2018] [Indexed: 12/16/2022] Open
Abstract
Oxidative damage is the causal link to a multitude of pathologies, such as diabetes, arthritis, neuropathy, heart disease, and asthma. These conditions affect hundreds of millions of people nationwide, and billions worldwide. Even in otherwise healthy individuals, oxidative stress is a natural byproduct of metabolism that is augmented in "healthy" activities such as athletics. In many disease states, the pharmacological agents used to treat these conditions can induce oxidative damage and vitamin depletion. It is underappreciated by many that many of the most common medications prescribed result in oxidative stress. Therefore, physicians need to carefully scrutinize which medications their patients are on before surgery and treatment and during the recovery stage to obtain optimal healing results. We provide a review of the current literature of how oxidative damage and inflammation are linked to bone damage, Charcot neuroarthropathy, delayed wound healing, diabetic complications, and delayed flap consolidation. Where available, antioxidant intervention literature is offered to offset these conditions.
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Sun X, Zheng R, Cheng L, Zhao X, Jin R, Zhang L, Zhang Y, Zhang Y, Cui W. Two-dimensional electrospun nanofibrous membranes for promoting random skin flap survival. RSC Adv 2016. [DOI: 10.1039/c5ra23034a] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Electrospun fibrous membranes made of natural materials are more advantageous for random skin flap survival, and can be used as carrier implantation materials for improving skin flap survival rate.
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Affiliation(s)
- Xiaoming Sun
- Department of Plastic and Reconstructive Surgery
- Ninth People's Hospital affiliated to Medical School of Shanghai Jiao Tong University
- Shanghai 200011
- P.R. China
| | - Reila Zheng
- Department of Orthopedics
- The First Affiliated Hospital of Soochow University
- Orthopedic Institute
- Soochow University
- Suzhou
| | - Liying Cheng
- Department of Plastic and Reconstructive Surgery
- Ninth People's Hospital affiliated to Medical School of Shanghai Jiao Tong University
- Shanghai 200011
- P.R. China
| | - Xin Zhao
- Department of Orthopedics
- The First Affiliated Hospital of Soochow University
- Orthopedic Institute
- Soochow University
- Suzhou
| | - Rong Jin
- Department of Plastic and Reconstructive Surgery
- Ninth People's Hospital affiliated to Medical School of Shanghai Jiao Tong University
- Shanghai 200011
- P.R. China
| | - Lu Zhang
- Department of Plastic and Reconstructive Surgery
- Ninth People's Hospital affiliated to Medical School of Shanghai Jiao Tong University
- Shanghai 200011
- P.R. China
| | - Ying Zhang
- Department of Plastic and Reconstructive Surgery
- Ninth People's Hospital affiliated to Medical School of Shanghai Jiao Tong University
- Shanghai 200011
- P.R. China
| | - Yuguang Zhang
- Department of Plastic and Reconstructive Surgery
- Ninth People's Hospital affiliated to Medical School of Shanghai Jiao Tong University
- Shanghai 200011
- P.R. China
| | - Wenguo Cui
- Department of Orthopedics
- The First Affiliated Hospital of Soochow University
- Orthopedic Institute
- Soochow University
- Suzhou
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