TY - JOUR AU - Kruit, A.S. AU - Brouwers, K. AU - Midden, D. van AU - Zegers, H.J.H. AU - Koers, E.J. AU - Alfen, N. van AU - Hummelink, S.L.M. AU - Ulrich, D.J.O. PY - 2021 UR - https://hdl.handle.net/2066/231785 AB - The current standard for composite tissue preservation is static cold storage (SCS) and is limited to 6 h until irreversible muscle damage occurs. Extracorporeal perfusion (ECP) is a promising technique for prolonged preservation, however, functional results have been scarcely researched. This article assessed neuromuscular function and compared results to histological alterations to predict muscle damage after ECP. Forelimbs of twelve Dutch landrace pigs were amputated and preserved by 4 h SCS at 4-6 °C (n = 6) or 18 h mid-thermic ECP with University of Wisconsin solution (n = 6). Limbs were replanted and observed for 12 h. Sham surgery was performed on contralateral forelimbs (n = 12). Histology analysis scored four subgroups representing different alterations (higher score equals more damage). Muscle contraction after median nerve stimulation was comparable between ECP, SCS, and sham limbs (P = 0.193). Histology scores were higher in ECP limbs compared to SCS limbs (4.8 vs. 1.5, P = 0.013). This was mainly based on more oedema in these limbs. In-vivo muscle contraction was well preserved after 18 h ECP compared to short SCS, although histology seemed inferior in this group. Histology, therefore, did not correlate to muscle function at 12 h after replantation. This leads to the question whether histology or neuromuscular function is the best predictor for transplant success. TI - Successful 18-h acellular extracorporeal perfusion and replantation of porcine limbs - Histology versus nerve stimulation EP - 375 SN - 0934-0874 IS - iss. 2 SP - 365 JF - Transplant International VL - vol. 34 DO - https://doi.org/10.1111/tri.13802 ER - TY - JOUR AU - Slater, N.J. AU - Zegers, H.J. AU - Kusters, B. AU - Beune, T. AU - Swieten, H.A. van AU - Ulrich, D.J.O. PY - 2016 UR - https://hdl.handle.net/2066/167782 AB - BACKGROUND: Under ideal circumstances, creation of the anastomosis during free flap transfer is a routine task and can be performed under short ischemia time. However, vessels may be in suboptimal state due to atherosclerosis, radiotherapy or trauma, increasing difficulties regarding receptor vessel identification, and anastomosis which in turn may lead to lengthening of ischemia time resulting in postoperative wound problems or even flap loss. In the current pilot study, a modified heart-lung machine was assembled to achieve continuous oxygenated extracoporeal perfusion using porcine myocutaneous rectus abdominis flaps, aimed at minimizing tissue damage occurring during ischemia time. MATERIALS AND METHODS: Different pilot test groups with n = 2 were created, including oxygenated perfusion with heparinized autologous blood or organ preservation solutions. Control groups included short flush with preservation solution followed by cold storage. RESULTS: Flaps were successfully attached to the modified heart-lung machine while maintaining stable flow throughout the 24-h experiments. Flaps undergoing continuous oxygenated perfusion with preservation solutions showed minimal or no signs of cell necrosis during the 24-h experiment, in contrast to using heparinized autologous blood or flushing and cold storage. CONCLUSIONS: The use of a modified heart-lung machine for oxygenated perfusion of free flaps provides new possibilities to minimize tissue damage during ischemia time, and further study of its use is warranted. TI - Ex-vivo oxygenated perfusion of free flaps during ischemia time: a feasibility study in a porcine model and preliminary results EP - 295 SN - 0022-4804 IS - iss. 2 SP - 292 JF - Journal of Surgical Research VL - vol. 205 DO - https://doi.org/10.1016/j.jss.2016.06.096 ER - TY - JOUR AU - Bauland, C.G. AU - Smit, J.M. AU - Scheffers, S.M. AU - Bartels, R.H.M.A. AU - Berg, P. van den AU - Zeebregts, C.J.A. AU - Spauwen, P.H.M. PY - 2012 UR - https://hdl.handle.net/2066/109533 AB - AIM: In an earlier study we have shown that transcervical chorionic villus sampling in excess of 90 mg increases the risk for hemangiomas of infancy three- to four-fold compared to amniocentesis. In the present study we investigated whether transabdominal chorionic villus sampling (TA-CVS), in which the samples are smaller, carries the same risk. MATERIAL AND METHODS: Retrospectively, data were analyzed from 200 consecutive TA-CVS procedures and 200 consecutive amniocentesis procedures. Forty-two TA-CVS procedures and 27 amniocentesis procedures were excluded on predefined criteria. Questionnaires were sent to the parents asking if there was any skin mark on the child: vascular, pigmented or otherwise. All hemangiomas were clinically confirmed. RESULTS: In the TA-CVS group, 118/158 questionnaires (75%), and in the amniocentesis group 134/173 questionnaires (77%) were returned. Based on the results of the questionnaire (i.e. mentioning of any skin lesion), 24 children in the TA-CVS group and 42 children in the amniocentesis group qualified for a physical examination. In the TA-CVS group 11/118 children (9%) had one or more hemangiomas. In the amniocentesis group 6/134 children (4%) had one or more hemangiomas. There was no statistical difference between the two groups (P = 0134). CONCLUSION: These results suggest that TA-CVS does not cause an increase in the prevalence of hemangioma compared to amniocentesis. A larger series is, however, necessary to confirm this. TI - Similar risk for hemangiomas after amniocentesis and transabdominal chorionic villus sampling. EP - 375 SN - 1341-8076 IS - iss. 2 SP - 371 JF - Journal of Obstetrics and Gynaecology Research VL - vol. 38 N1 - 1 februari 2012 DO - https://doi.org/10.1111/j.1447-0756.2011.01717.x ER - TY - JOUR AU - Sagar, B. AU - Marres, H.A.M. AU - Hartman, E.H.M. PY - 2010 UR - https://hdl.handle.net/2066/88259 AB - The aim of this retrospective study is to evaluate short- and long-term postoperative morbidity and mortality of hypopharyngeal resection and reconstruction. Patients with laryngopharyngeal malignancies were treated with laryngopharyngectomy and the resulting defect was reconstructed with an anterolateral thigh flap. The study group consisted of 20 patients with one or more primary hypopharyngeal carcinomas or a relapse of this tumour. All patients were diagnosed and operated in the University Medical Center between February 2000 and July 2007. Data were collected from the clinical medical files of the departments of plastic surgery and oto-rhino-laryngology. The dietetic and speech therapy files were used as well. To study the quality of life, the Dutch version of the University of Washington Quality of Life questionnaire was sent to all surviving patients. The microsurgical reconstructions were 100% successful. Fifteen patients (75.0%) died during the follow-up period; the 5-year overall survival was 20%. Complications such as post-surgical fistulas and strictures requiring surgical intervention were found in five (25.0%) and six patients (30.0%), respectively. Other post-surgical complications such as wound dehiscence were seen in two patients (10.0%). The incidence of donor-site complications at the thigh was very low. No significant relationship was found among preoperative patients' characteristics like age, gender, preoperative radiotherapy, the TNM (tumour, node, metastasis) classification of the tumour and the risk of post-surgical complications. The number and/or the severity of the complications were not significantly associated with the duration of surgery or ischaemia time. In our view, surgery is a good option in the treatment of these patients. Although curative treatment is the best outcome, a satisfactory palliation in itself can be a justification for this type of surgery. Although only seven patients were able to answer the QOL questionnaire, the positive judgements of these patients support this view point. TI - Hypopharyngeal reconstruction with an anterolateral thigh flap after laryngopharyngeal resection: results of a retrospective study on 20 patients. EP - 975 SN - 1748-6815 IS - iss. 6 SP - 970 JF - Journal of Plastic Reconstructive and Aesthetic Surgery VL - vol. 63 N1 - 1 juni 2010 DO - http://dx.doi.org/10.1016/j.bjps.2009.04.019 ER -