gms | German Medical Science

128. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

03.05. - 06.05.2011, München

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

Meeting Abstract

  • Adrian Dragu - Universitätsklinikum der Friedrich-Alexander-Universität Erlangen-Nürnberg, Klinik für Plastische und Handchirurgie, Erlangen
  • T. Birkholz - Universitätsklinikum der Friedrich-Alexander-Universität Erlangen-Nürnberg, Klinik für Plastische und Handchirurgie, Erlangen
  • J.A. Kleinmann - Universitätsklinikum der Friedrich-Alexander-Universität Erlangen-Nürnberg, Klinik für Plastische und Handchirurgie, Erlangen
  • S. Schnürer - Universitätsklinikum der Friedrich-Alexander-Universität Erlangen-Nürnberg, Klinik für Plastische und Handchirurgie, Erlangen
  • F. Münch - Universitätsklinikum der Friedrich-Alexander-Universität Erlangen-Nürnberg, Klinik für Plastische und Handchirurgie, Erlangen
  • P. Cesnjevar - Universitätsklinikum der Friedrich-Alexander-Universität Erlangen-Nürnberg, Klinik für Plastische und Handchirurgie, Erlangen
  • J. Schmidt - Universitätsklinikum der Friedrich-Alexander-Universität Erlangen-Nürnberg, Klinik für Plastische und Handchirurgie, Erlangen
  • R.E. Horch - Universitätsklinikum der Friedrich-Alexander-Universität Erlangen-Nürnberg, Klinik für Plastische und Handchirurgie, Erlangen

Deutsche Gesellschaft für Chirurgie. 128. Kongress der Deutschen Gesellschaft für Chirurgie. München, 03.-06.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11dgch393

DOI: 10.3205/11dgch393, URN: urn:nbn:de:0183-11dgch3932

Published: May 20, 2011

© 2011 Dragu et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Introduction: The scientific understanding and techniques in the field of organ transplantation have made extraordinary progress within the last two decades. However, the transplantation of free tissue flaps remains an area in which the understanding of mechanisms during ischemia and reperfusion is low. Thus, the prolongation of ischemic time and the possibility to perform an ex vivo perfusion of such free tissue flaps is clinically but also for scientific reasons desirable. The purpose of this study was to create a closed and steady ex vivo perfusion system in order to analyze the possibility using a miniaturized perfusion system for free muscle flaps.

Materials and methods: The rectus abdominis muscles of 6 german pigs, weighing 36 to 38 kg were used in the study. Each of these free muscle flaps was perfused with 10 ml/min Jonosteril (Fresenius Jonosteril, Fresenius Kabi Germany) with 5000 I.E. Heparin for a period of one to two hours using a pulsatil and closed pump perfusion system (BRAUN Infusomat® Space P, Germany) by canulating 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 6 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 two hours.

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 two hours.