Hydroxyethyl starch solution for extracorporeal tissue perfusion.

Area of Science:

• Reconstructive Surgery
• Tissue Engineering
• Organ Transplantation

Background:

• Ischemia during free flap transfer causes significant cell damage.
• Previous studies demonstrated muscle transplant conservation via extracorporeal perfusion with crystalloid solutions.
• Significant edema formation was observed with crystalloid perfusion.

Purpose of the Study:

• To reduce edema formation in muscle transplants during extracorporeal perfusion.
• To evaluate hydroxyl-ethyl starch (a colloid) as a perfusion solution.
• To assess the potential benefits of colloid use in preserving muscle viability.

Main Methods:

• Extracorporeal perfusion of muscle tissue for 6 hours.
• Comparison of crystalloid versus iso-oncotic colloid (hydroxyl-ethyl starch) perfusion solutions.
• Assessment of muscle functionality via external field stimulation.
• Histological examination and measurement of edema formation.
• Annexin V used as a marker for cell damage.

Main Results:

• Perfused muscles demonstrated statistically significant higher force generation compared to nonperfused controls.
• Perfusion significantly limited cell damage, as indicated by Annexin V.
• Colloid perfusion showed a trend toward reduced edema formation, but without statistical significance.

Conclusions:

• Extracorporeal perfusion is effective in preserving muscle function and limiting cell damage.
• Hydroxyl-ethyl starch as a colloid solution has potential for reducing edema, warranting further investigation.
• Optimizing perfusion solutions is crucial for improving outcomes in reconstructive surgery and tissue transplantation.