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DOI: 10.1055/s-0032-1329924
Microvascular Effects of Subatmospheric Pressure in Striated Muscle
Publikationsverlauf
01. Juli 2012
25. August 2012
Publikationsdatum:
04. Januar 2013 (online)
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Abstract
Objective Topical application of subatmospheric pressure (TASAP) promotes faster wound healing, but tissue effects are not entirely understood. This study investigated microvascular effects of TASAP in striated muscle with the hypothesis being that TASAP elicits arteriolar vasodilation and decreases interstitial accumulation of protein.
Methods Rat cremasteric microcirculation was directly examined in two experiments utilizing a novel technique. First, TASAP was applied to the cremaster in three experimental groups and a non-TASAP control group. Arteriolar diameters were directly measured before and after TASAP. In experiment two, intravascular fluorescein isothiocyanate (FITC)-labeled albumin and topical leukotriene B4 (LTB4) were delivered to the cremaster. Microvascular permeability was assessed by measuring the accumulation/disappearance of FITC-albumin in the interstitial tissue.
Results TASAP produced significant arteriolar vasodilation compared with control values. The mean maximum percent increase in diameter with TASAP was 8.70% at −2 kPa (p < 0.05), 7.16% at −4 kPa (p < 0.05), and 10.43% at −6 kPa (p < 0.01). TASAP decreased interstitial FITC-albumin by 26.3% (p < 0.008) following LTB4; the control group showed a steady increase in interstitial FITC-albumin.
Conclusions These results support the hypothesis that TASAP elicits significant arteriolar vasodilation with a subsequent increase in blood flow as well as a decrease in interstitial protein accumulation.
Keywords
topical subatmospheric pressure - vasodilation - blood flow - vacuum-assisted closure - microvascular permeabilityNote
Research performed at Wake Forest Baptist Medical Center, Department of Orthopaedic Surgery, Winston-Salem, NC 27157.
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References
- 1 Bickels J, Kollender Y, Wittig JC, Cohen N, Meller I, Malawer MM. Vacuum-assisted wound closure after resection of musculoskeletal tumors. Clin Orthop Relat Res 2005; 441: 346-350
- 2 Giovannini UM, Settembrini F, Colonna MR , et al. Topical negative therapy and vacuum assisted closure. New strategies and devices in surgical reconstruction. Minerva Chir 2005; 60: 191-194
- 3 Lee AT, Fanton GS, McAdams TR. Acute compartment syndrome of the thigh in a football athlete: a case report and the role of the vacuum-assisted wound closure dressing. J Orthop Trauma 2005; 19: 748-750
- 4 Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg 1997; 38: 553-562
- 5 Plikaitis CM, Molnar JA. Subatmospheric pressure wound therapy and the vacuum-assisted closure device: basic science and current clinical successes. Expert Rev Med Devices 2006; 3: 175-184
- 6 Van der Velde M, Hudson DA. VADER (vacuum-assisted dermal recruitment): a new method of wound closure. Ann Plast Surg 2005; 55: 660-664
- 7 Molnar JA, Simpson JL, Voignier DM, Morykwas MJ, Argenta LC. Management of an acute thermal injury with subatmospheric pressure. J Burns Wounds 2005; 4: e5
- 8 Morykwas MJ, Simpson J, Punger K, Argenta A, Kremers L, Argenta J. Vacuum-assisted closure: state of basic research and physiologic foundation. Plast Reconstr Surg 2006; 117 (7, Suppl) 121S-126S
- 9 Takamatsu Y, Shimada K, Chijiiwa K, Kuroki S, Yamaguchi K, Tanaka M. Role of leukotrienes on hepatic ischemia/reperfusion injury in rats. J Surg Res 2004; 119: 14-20
- 10 Baez S. An open cremaster muscle preparation for the study of blood vessels by in vivo microscopy. Microvasc Res 1973; 5: 384-394
- 11 Smith TL, Wong-Gibbons D, Maultsby J. Microcirculatory effects of pulsed electromagnetic fields. J Orthop Res 2004; 22: 80-84
- 12 Saxena V, Hwang C-W, Huang S, Eichbaum Q, Ingber D, Orgill DP. Vacuum-assisted closure: microdeformations of wounds and cell proliferation. Plast Reconstr Surg 2004; 114: 1086-1096 , discussion 1097–1098
- 13 Venturi ML, Attinger CE, Mesbahi AN, Hess CL, Graw KS. Mechanisms and clinical applications of the vacuum-assisted closure (VAC) Device: a review. Am J Clin Dermatol 2005; 6: 185-194
- 14 Wackenfors A, Sjögren J, Algotsson L, Gustafsson R, Ingemansson R, Malmsjö M. The effect of vacuum-assisted closure therapy on the pig femoral artery vasomotor responses. Wound Repair Regen 2004; 12: 244-251
- 15 Ichioka S, Watanabe H, Sekiya N, Shibata M, Nakatsuka T. A technique to visualize wound bed microcirculation and the acute effect of negative pressure. Wound Repair Regen 2008; 16: 460-465
- 16 Lindstedt S, Malmsjö M, Ingemansson R. Blood flow changes in normal and ischemic myocardium during topically applied negative pressure. Ann Thorac Surg 2007; 84: 568-573
- 17 Wackenfors A, Gustafsson R, Sjögren J, Algotsson L, Ingemansson R, Malmsjö M. Blood flow responses in the peristernal thoracic wall during vacuum-assisted closure therapy. Ann Thorac Surg 2005; 79: 1724-1730 , discussion 1730–1731
- 18 Borgquist O, Anesäter E, Hedström E, Lee CK, Ingemansson R, Malmsjö M. Measurements of wound edge microvascular blood flow during negative pressure wound therapy using thermodiffusion and transcutaneous and invasive laser Doppler velocimetry. Wound Repair Regen 2011; 19: 727-733
- 19 Deal DN, Tipton J, Rosencrance E, Curl WW, Smith TL. Ice reduces edema. A study of microvascular permeability in rats. J Bone Joint Surg Am 2002; 84-A: 1573-1578
- 20 Wiig H, Rubin K, Reed RK. New and active role of the interstitium in control of interstitial fluid pressure: potential therapeutic consequences. Acta Anaesthesiol Scand 2003; 47: 111-121
- 21 Kamolz LP, Andel H, Haslik W, Winter W, Meissl G, Frey M. Use of subatmospheric pressure therapy to prevent burn wound progression in human: first experiences. Burns 2004; 30: 253-258
- 22 Simman R, Forte R, Silverberg B, Moriera-Gonzalez A, Williams F. A comparative histological study of skin graft take with tie-over bolster dressing versus negative pressure wound therapy in a pig model: A preliminary study. Wounds 2004; 16: 76-80
- 23 Norbury K, Kieswetter K. Vacuum Assisted Closure Therapy Attenuates the Inflammatory Response in a Porcine Acute Wound Healing Model. Wounds 2007; 19: 97-106
- 24 von der Weid P-Y, Zawieja DC. Lymphatic smooth muscle: the motor unit of lymph drainage. Int J Biochem Cell Biol 2004; 36: 1147-1153