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Flap-Based Perfusion System for Long-Term Ex Vivo Modelling of Wound Healing and Metabolism
Yusuf Surucu, MD; José Antonio Arellano, MD; Katherine S. Yang, BS, Alexey Altman, BSc, Zayan Tirmizi, BSc; Rakibul Islam, BSc; Baris F. Bengur, MD; Shawn Loder, MD; Yadira Villalvazo, MD; Jeffrey A. Gusenoff, MD; AsimEjaz, PhD.
University of Pittsburgh
2023-02-10
Presenter: Yusuf Surucu
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.
Director Name: J. Peter Rubin, MD, MBA
Author Category: Fellow Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
Introduction:
Current preclinical methods used for wound healing and metabolic research has limitations as they lack complete physiology and anatomy of human tissue. Here we describe a surgical waste-based skin perfusion system to cultivate full-thickness skin flaps ex vivo for up to 2 weeks.
Methods:
Abdominal panniculectomy samples were collected as surgical waste. We isolated and cannulated superficial epigastric system. Angiography, perfusion monitoring, hormonal reactivity tests, histology, cell viability, lactate and glucose rate, and expression analyses were performed to assess the viability of the flap.
Results:
Angiography verified that the SIEA/V flap system successfully fed 80% of a large(400cm2) flap. Hormonal reactivity tests showed significant response to insulin and catecholamines; equivalent results achieved at days 5 and 12. Stainings confirmed preservation of vascular and dermal epithelium. TUNEL stainings showed preservation of cell viability. Electron microscopy showed intact and healthy cellular components and organelles. Glucose consumption and lactate and adiponectin production showed healthy and stable flap metabolism. When perfusion system was compared to explant culture; perfusion system preserved epidermal, dermal, and adipose viability contrary showed by explant culture. Perfusion prevented ischemia related apoptosis and down regulated apoptotic gene and protein expression. Flow rate and pressure remained steady throughout ex vivo cultivation.
Conclusions:
This system can be used to perfuse the tissue during and after pathology, allowing immediate and longitudinal data collection. This viable system can help us understand the treatment options and be used as a subclinical drug testing model for wide range of diseases.
