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Flap preconditioning by pressure-controlled cupping in a rat model.

Kyung S Koh1, Sung Woo Park1, Tae Suk Oh1

  • 1Department of Plastic Surgery, Asan Medical Center, University of Ulsan, Seoul, Korea.

The Journal of Surgical Research
|August 28, 2016
PubMed
Summary

Noninvasive cupping therapy using controlled negative pressure effectively enhances flap survival by improving blood flow and vascularity. This preconditioning method promotes tissue perfusion and aids soft-tissue reconstruction in a rat model.

Keywords:
CuppingPreconditioningRandom flapRats

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Area of Science:

  • Regenerative Medicine
  • Vascular Biology
  • Surgical Innovation

Background:

  • Flap survival is critical for successful soft-tissue reconstruction, with current methods focusing on enhancing blood supply.
  • Traditional preconditioning techniques aim to increase blood flow through vasodilation or vascular reorientation.
  • External stress methods like cupping can induce vascular remodeling, with applications in fat grafting and traditional medicine.

Purpose of the Study:

  • To evaluate the effectiveness of noninvasive cupping therapy as a preconditioning method to improve flap survival.
  • To investigate the impact of controlled negative pressure on vascular remodeling and tissue perfusion in a flap model.

Main Methods:

  • A rat random-pattern dorsal flap model was utilized.
  • Preconditioning involved applying controlled negative pressure (-25 mm Hg) for 30 minutes daily for 5 days using a specialized cupping device.
  • Flap viability, tissue perfusion (laser Doppler imaging), and histological changes were assessed post-surgery over a 9-day observation period.

Main Results:

  • The preconditioned group demonstrated a significant increase in flap viability (19.0% absolute increase, 70.1% vs. 51.0%).
  • Tissue perfusion improved by 24.2% (absolute increase, 77.4% vs. 53.1%) in the preconditioned flaps.
  • Histological analysis revealed increased vascular density in the subdermal plexus and enhanced collagen organization with muscle hypertrophy.

Conclusions:

  • Controlled noninvasive suction preconditioning effectively induces vascular remodeling.
  • This method significantly increases tissue perfusion and improves flap survival in a rat model.
  • Cupping therapy presents a promising noninvasive approach for enhancing flap viability in reconstructive surgery.