An old dream revitalised: preconditioning strategies to protect surgical flaps from critical ischaemia and ischaemia-reperfusion injury

Article Article scientifique Revue de la littérature An old dream revitalised: preconditioning strategies to protect surgical flaps from critical ischaemia and ischaemia-reperfusion injury eng 2008 author Harder Yves 642638 author Amon M. author Laschke M. W. author Schramm R. author Rucker M. author Wettstein Reto 652149 author Bastiaanse J. author Frick A. author Machens H-G author Kuntscher M. author Germann Georg 110212 author Vollmar B. author Erni Dominik 643456 author Menger M. D. 503-511 10.1016/j.bjps.2007.11.032 18166506 1748-6815 http://pdn.sciencedirect.com/science?_ob=MiamiImageURL&_cid=273464&_user=9565874&_pii=S1748681507006316&_check=y&_origin=article&_zone=toolbar&_coverDate=31-May-2008&view=c&originContentFamily=serial&wchp=dGLzVlt-zSkzV&md5=20a1068b27c6e2791870d9928631ac7c/1-s2.0-S1748681507006316-main.pdf The prevention of ischaemia and the adequate restitution of blood flow to ischaemic tissue are pivotal to halt the progression of cellular injury associated with decreased oxygen and nutrient supply. Accordingly, the search for novel strategies which aim at preventing ischaemia-reperfusion-induced tissue damage is still of major interest in flap surgery. Preconditioning represents an elegant approach to render the tissue more resistant against deleterious ischaemic insults. For many decades, 'surgical delay' has been the standard method of tissue preconditioning. During the last 10 years, ischaemic preconditioning was added to the repertoire of plastic surgeons to protect flaps from ischaemic necrosis. The invasiveness and expenditure of time of these procedures, however, have always been major drawbacks, hindering a wide distribution in clinical practice. Consequently, the motivation has all along been to further refine and simplify protective strategies. Recent experimental studies have now shown that efficient protection from ischaemic necrosis can also be achieved by remote preconditioning or pretreatment with chemical agents and growth factors, which mimic the action of surgical delay and ischaemic preconditioning. In addition, the local application of unspecific stressors, including both heating and cooling, have been shown to effectively improve flap microcirculation and, thus, tissue survival. In view of successful translational research, it is now time that the efficacy of these novel preconditioning procedures is proven in prospective randomised clinical trials. Growth Substances/therapeutic use Humans Hyperthermia, Induced/methods Hypothermia, Induced/methods Ischemic Preconditioning/*methods Microcirculation Reperfusion Injury/*prevention & control Surgical Flaps/*blood supply Dewey 617 57 Département de chirurgie 222 false Journal of plastic, reconstructive & aesthetic surgery 61 5 42c816a3-75be-4b4b-ba12-3c10793a01d4 Article Restricted file1.pdf 222130 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département de chirurgie

Title	Published in	Access level	OA Policy	Year	Views	Downloads

An old dream revitalised: preconditioning strategies to protect surgical flaps from critical ischaemia and ischaemia-reperfusion injury	Journal of plastic, reconstructive & aesthetic surgery			2008	572	0

Archive ouverte UNIGE

Germann, Georg