Tissue Viability of Free Flaps after Extracorporeal Perfusion Using a Modified Hydroxyethyl Starch Solution

Area of Science:

• Biomedical Engineering
• Surgical Research
• Tissue Preservation

Background:

• Free flap surgery often involves hypothermic ischemic storage of tissues.
• Extracorporeal perfusion (EP) offers a potential method to extend tissue viability during storage.
• This study aimed to enhance a previously developed simplified EP system.

Purpose of the Study:

• To evaluate the efficacy of a simplified extracorporeal perfusion system for preserving porcine rectus abdominis muscles.
• To compare continuous perfusion with static cold storage and single flush methods.
• To assess the impact of a modified hydroxyethyl starch solution on tissue preservation.

Main Methods:

• Porcine rectus abdominis muscles were subjected to either continuous EP for six hours or static storage with a single flush.
• A simplified one-way perfusion system was utilized.
• A modified hydroxyethyl starch solution served as the perfusion and flushing agent.
• Tissue vitality, functionality, and metabolic activity were analyzed.

Main Results:

• Continuous EP demonstrated superior tissue preservation compared to static storage.
• Perfused muscles exhibited no loss of vitality and significantly reduced functional decline.
• The modified hydroxyethyl starch solution further improved preservation outcomes compared to previous studies.

Conclusions:

• Extracorporeal perfusion provides significant advantages over static cold storage for tissue preservation.
• Continuous perfusion ensures oxygen and nutrient supply while removing harmful metabolites.
• The improved EP system shows promise for enhancing outcomes in free flap surgery.