单位：[1]Tissue Engineering and Wound Healing Laboratory, Department of Surgery, Division of Plastic Surgery, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA[2]Department of Molecular Medicine, University of Padova, 35131 Padua, Italy[3]Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200125, China[4]Department of Plastic Surgery, China-Japan Friendship Hospital, Beijing 100029, China[5]Preventive Medicine, University of New Mexico, Albuquerque, NM 87131, USA[6]Nephrology Division, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA[7]International Center for T1D, Romeo ed Enrica Invernizzi Pediatric Clinical Research Center, Department of Biomedical and Clinical Science L. Sacco, University of Milan and ASST Fatebenefratelli-Sacco, Milan, Italy
In reconstructive surgery, tissues are routinely transferred to repair a defect caused by trauma, cancer, chronic diseases, or congenital malformations; surgical transfer intrinsically impairs metabolic supply to tissues placing a risk of ischemia-related complications such as necrosis, impaired healing, or infection. Pre-surgical induction of angiogenesis in tissues (preconditioning) can limit postsurgical ischemic complications and improve outcomes, but very few preconditioning strategies have successfully been translated to clinical practice due to the invasiveness of most proposed approaches, their suboptimal effects, and their challenging regulatory approval. We optimized a method that adopts noninvasive external suction to precondition tissues through the induction of hypoxia-mediated angiogenesis. Using a sequential approach in a rodent model, we determined the parameters of application (frequency, suction levels, duration, and interfaces) that fine-tune the balance of enhanced angiogenesis, attenuation of hypoxic tissue damage, and length of treatment. The optimized repeated short-intermittent applications of intermediate suction induced a 1.7-fold increase in tissue vascular density after only 5 days of treatment (p < 0.05); foam interfaces showed the same effectiveness and caused less complications. In a second separate experiment, our model showed that the optimized technique significantly improves survival of transferred tissues. Here we demonstrate that noninvasive external suction can successfully, safely, and promptly enhance vascularity of soft tissues: these translational principles can help design effective preconditioning strategies, transform best clinical practice in surgery, and improve patient outcomes.
基金：
Plastic Surgery Foundation; Gillian Reny Stepping Strong Fund; KCI, Inc; Fondazione Romeo and Enrica Invernizzi
第一作者单位：[1]Tissue Engineering and Wound Healing Laboratory, Department of Surgery, Division of Plastic Surgery, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA[2]Department of Molecular Medicine, University of Padova, 35131 Padua, Italy
共同第一作者：
通讯作者：
通讯机构：[1]Tissue Engineering and Wound Healing Laboratory, Department of Surgery, Division of Plastic Surgery, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA[2]Department of Molecular Medicine, University of Padova, 35131 Padua, Italy
推荐引用方式(GB/T 7714)：
G. Giatsidis,L. Cheng,A. Haddad,et al.Noninvasive induction of angiogenesis in tissues by external suction: sequential optimization for use in reconstructive surgery[J].ANGIOGENESIS.2018,21(1):61-78.doi:10.1007/s10456-017-9586-1.
APA：
G. Giatsidis,L. Cheng,A. Haddad,K. Ji,J. Succar...&D. P. Orgill.(2018).Noninvasive induction of angiogenesis in tissues by external suction: sequential optimization for use in reconstructive surgery.ANGIOGENESIS,21,(1)
MLA：
G. Giatsidis,et al."Noninvasive induction of angiogenesis in tissues by external suction: sequential optimization for use in reconstructive surgery".ANGIOGENESIS 21..1(2018):61-78
医学