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Preventing graft loss caused by hematoma: experimental study
Erol Benlier1, Süleyman Taş, Ufuk Usta
1From the Departments of *Plastic, Reconstructive and Aesthetic Surgery and †Pathology, Trakya University Medicine Faculty, Edirne, Turkey.
Abstract:
Hematoma is a common reason for graft loss. This study was intended to investigate the effects of microporous polysaccharide hemospheres (MPH; Arista® AH; Medafor, Inc.) on graft survival, the effect of MPH on graft loss caused by hematoma, and the correlation between neutrophil accumulation and graft survival. A total of 35 adult male Wistar rats were separated into five groups of seven as follows: control 1, saline, MPH, control 2 (hematoma group), and MPH + hematoma. All graft dressing was removed on the fifth postoperative day and graft survival percentage measured. Histopathological and semiquantitative analysis, including inflammatory cell infiltration and subcutaneous inflammation based on neutrophil count, was performed. Graft survival significantly improved in the MPH group (97.86 ± 1.676) compared with the control 1 (91.14 ± 3.671; P = .004) and saline groups (91.57 ± 4.791; P = .014). There was no significant increase in graft survival in the saline group compared with the control 1 group or in the MPH + hematoma group (19.57 ± 14.707) compared with the control 2 group (20.71 ± 16.869; P > .05). The neutrophil count was highest in the control 2 group (177.43 ± 22.464) and significantly decreased in the MPH group (33. 71 ± 8,674) compared with the control 1 group (66.14 ± 5.872; P = .001) and the saline group (65.57 ± 3.309; P= .001). There was no significant decrease in neutrophil count in the MPH + hematoma group (160.00 ± 27.952) compared with the control 2 group (P > .05). It seems that MPH can increase the graft survival, and there is an inverse relationship between graft survival and neutrophil accumulation.
Insights
Microporous polysaccharide hemospheres (MPH) significantly improved graft survival by reducing neutrophil accumulation. However, MPH did not prevent graft loss caused by hematoma in this study.
Area of Science:
- Biomedical Engineering
- Surgical Research
- Wound Healing
Background:
- Hematoma formation is a primary cause of graft failure.
- Understanding factors influencing graft survival is crucial for improving surgical outcomes.
- Neutrophil accumulation plays a role in inflammatory responses post-grafting.
Purpose of the Study:
- To evaluate the efficacy of microporous polysaccharide hemospheres (MPH) in enhancing graft survival.
- To determine the impact of MPH on graft loss attributed to hematoma.
- To investigate the correlation between neutrophil infiltration and graft survival rates.
Main Methods:
- A Wistar rat model was used with five experimental groups: control, saline, MPH, hematoma, and MPH + hematoma.
- Graft survival was assessed on postoperative day five.
- Histopathological analysis, including neutrophil counts, quantified inflammation and tissue response.
Main Results:
- MPH treatment significantly increased graft survival compared to control and saline groups (97.86% vs. 91.14% and 91.57%).
- Graft survival in the MPH + hematoma group was not significantly different from the hematoma-only control group.
- Neutrophil counts were significantly lower in the MPH group compared to controls, indicating reduced inflammation.
Conclusions:
- Microporous polysaccharide hemospheres demonstrate potential in improving graft survival, likely by modulating inflammatory cell infiltration.
- MPH efficacy is diminished when significant hematoma formation occurs, suggesting limitations in preventing hematoma-induced graft loss.
- An inverse relationship exists between graft survival and neutrophil accumulation, highlighting neutrophils as a key factor in graft outcomes.
