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- Title
Caloric Restriction: A Novel Conditioning Strategy to Improve the Survival of Ischemically Challenged Musculocutaneous Random Pattern Flaps.
- Authors
Weinzierl, Andrea; Coerper, Maximilian; Harder, Yves; Menger, Michael D.; Laschke, Matthias W.
- Abstract
Caloric restriction (CR) is a cost-effective and easy-to-perform approach to counteracting surgical stress. The present study therefore evaluates the tissue-protective effects of a 30% CR in musculocutaneous flaps undergoing ischemia. For this purpose, a well-established murine dorsal skinfold chamber model, in combination with random pattern musculocutaneous flaps, was used. C57BL/6N mice were divided at random into a CR group (n = 8) and a control group with unrestricted access to standard chow (n = 8). The CR animals were subjected to a 30% reduction in caloric intake for 10 days before flap elevation. Intravital fluorescence microscopy was carried out on days 1, 3, 5, 7 and 10 after flap elevation to assess the nutritive blood perfusion, angiogenesis and flap necrosis. Subsequently, the flap tissue was harvested for additional histological and immunohistochemical analyses. The CR-treated animals exhibited a significantly higher functional capillary density and more newly formed microvessels within the flap tissue when compared to the controls; this was associated with a significantly higher flap survival rate. Immunohistochemical analyses showed a decreased invasion of myeloperoxidase-positive neutrophilic granulocytes into the flap tissue of the CR-treated mice. Moreover, the detection of cleaved caspase-3 revealed fewer cells undergoing apoptosis in the transition zone between the vital and necrotic tissue in the flaps of the CR-treated mice. These results demonstrate that a CR of 30% effectively prevents flap necrosis by maintaining microperfusion on a capillary level and inhibiting inflammation under ischemic stress. Hence, CR represents a promising novel conditioning strategy for improving the survival of musculocutaneous flaps with random pattern perfusion.
- Subjects
SWITZERLAND; DIET in disease; ISCHEMIA; IMMUNOCHEMISTRY; SURGICAL flaps; FOOD consumption; ANIMAL experimentation; MICROSCOPY; NEOVASCULARIZATION; MICROCIRCULATION; GRAFT survival; SURGICAL complications; DIET therapy; RESEARCH funding; OXIDOREDUCTASES; WOUNDS &; injuries; MICE; CASPASES
- Publication
Nutrients, 2023, Vol 15, Issue 18, p4076
- ISSN
2072-6643
- Publication type
Article
- DOI
10.3390/nu15184076