Name: ischemic tissue injury in the dorsal skinfold chamber of the mouse: a skin flap model to investigate acute persistent ischemia
Uploaded: 2014-11-17T14:00:00
Description: Watch this Scientific Journal Video about Ischemic Tissue Injury in the Dorsal Skinfold Chamber of the Mouse: A Skin Flap Model to Investigate Acute Persistent Ischemia at JoVE.com

We thank Katharina Haberland for image editing. &#160;Funding: The senior author received a KKF Grant from the Technische Universit&#228;t M&#252;nchen to set up a new research laboratory.

BEMÆRK: Inden gennemførelse af den præsenterede model, må love de tilsvarende dyrebeskyttelse høres og tilladelse skal indhentes fra de lokale myndigheder. I dette arbejde blev alle forsøg udføres i overensstemmelse med de vejledende principper for forskning, der omfatter dyr og den tyske lovgivning om beskyttelse af dyr. Forsøgene blev godkendt af de lokale dyr pleje udvalg. 1. Animalske Forberedelse og Kirurgisk Elevation af klappen <ol style="margin-left: 40px;"><li> Holde dyr i...

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M., Intaglietta, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quantitative+assessment+of+microhemodynamics+in+ischemic+skin+flap+tissue+by+intravital+microscopy.">Quantitative assessment of microhemodynamics in ischemic skin flap tissue by intravital microscopy.</a> Ann Plast Surg. 43, 405-414 (1999).</li><li>Roesken, F., Sch&#228;fer, T., Spitzer, W. J., Vollmar, B., Menger, M. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vivo+analysis+of+the+microcirculation+of+osteomyocutaneous+flaps+using+fluorescence+microscopy.">In vivo analysis of the microcirculation of osteomyocutaneous flaps using fluorescence microscopy.</a> Br J Plast Surg. 52, 644-652 (1999).</li><li>Harder, Y., Amon, M., Erni, D., Menger, M. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evolution+of+ischemic+tissue+injury+in+a+random+pattern+flap:+a+new+mouse+model+using+intravital+microscopy.">Evolution of ischemic tissue injury in a random pattern flap: a new mouse model using intravital microscopy.</a> J Surg Res. 121, 197-205 (2004).</li><li>Harder, Y., Contaldo, C., Klenk, J., Banic, A., Jakob, S. M., Erni, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preconditioning+with+monophosphoryl+lipid+A+improves+survival+of+critically+ischemic+tissue.">Preconditioning with monophosphoryl lipid A improves survival of critically ischemic tissue.</a> Anesth Analg. 100, 1786-1792 (2005).</li><li>Rezaeian, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Erythropoieton+protects+critically+perfused+flap+tissue.">Erythropoieton protects critically perfused flap tissue.</a> Ann Surg. 248, 919-929 (2008).</li><li>Harder, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Erythropoietin+reduces+necrosis+in+critically+ischemic+myocutaneous+tissue+by+protecting+nutritive+perfusion+in+a+dose-dependent+manner.">Erythropoietin reduces necrosis in critically ischemic myocutaneous tissue by protecting nutritive perfusion in a dose-dependent manner.</a> Surgery. 145, 10-1016 (2009).</li><li>Rezaeian, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Erythropoietin-induced+upregulation+of+endothelial+nitric+oxide+synthase+but+not+vascular+endothelial+growth+factor+prevents+musculocutaneous+tissue+from+ischemic+damage.">Erythropoietin-induced upregulation of endothelial nitric oxide synthase but not vascular endothelial growth factor prevents musculocutaneous tissue from ischemic damage.</a> Lab Invest. 90, 40-51 (2010).</li><li>Rezaeian, F., Ong, M. 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In order to decrease ischemic complications and thereby improve the clinical outcome, more detailed knowledge of pathophysiologic processes in critically perfused flap tissue is required. The development of new animal models that mimic acute persistent ischemia is therefore mandatory. Accordingly, we were able to develop an easily reproducible and reliable model allowing for repetitive morphological, dynamic and functional real-time evaluation of various parameters of muscle and skin vasculature that can be correlated wi...

Dækning af eksponeret sene, knogle og implantat materiale i rekonstruktionskirurgi bygger på anvendelsen af ​​flapper. En klap er en blok af væv, der overføres på vaskulære stilken, der garanterer arteriel indstrømning og venøs udstrømning. Trods bred ekspertise og tilgængeligheden af ​​en bred vifte af flapper, der skal overføres, er iskæmiinduceret komplikationer lige fra sår nedbrydning til total vævstab stadig stødt. Betragtninger kan forventes konservativ behandling og helbredelse ved sekundær intention efter mindre vævsnekrose, betydelig flap nekrose normalt kræver kirurgisk revision, herunder debridement, sår konditionering og sekundær rekonstruktion. Dette øger sygeligheden, forlænger hospitalsophold og dermed fører til øgede udgifter til sundhedspleje. Flapper med en udefineret mønster af vaskulatur eller tilfældigt perfunderede områder i den distale zone længst væk fra arteriel indstrømning er særligt tilbøjelige til iskæmisk skade. Acco<html> rdingly har adskillige eksperimentelle og kliniske undersøgelser evalueret udviklingen af nekrose i både aksial mønster klapper (defineret blodforsyning) og tilfældigt mønster klapper (udefineret blodforsyning) 1-3. De vigtigste resultater er almindeligt baseret på makroskopisk vurdering af størrelsen af ​​det nekrotiske område. For at vurdere årsagerne til og mekanismerne i vævsnekrose mere i detaljer, flere undersøgelser fokuseret på analysen af ​​mikrocirkulationen. Forskellige teknikker er blevet anvendt til at måle vævsperfusion, herunder en analyse af væv oxygenspænding hjælp polarografiske elektroder 4-5, samt måling af blodgennemstrømningen ved hjælp af laser Doppler-flowmetri 6-7, dye diffusion 8 og mikrosfærer 9-10. Disse teknikker imidlertid kun mulighed for at måle indirekte parametre vævsperfusion og ikke aktivere nogen morfologisk analyse af microhemodynamic processer i et enkelt område af interesse af en klap. t &quot;&gt; Sandison er kendt for at være de første, der har anvendt en transparent kammer til langvarig in vivo-undersøgelser, som han udførte i kaniner 11 I 1943 -. ca. 20 år senere - Algire var den første til at tilpasse en sådan transparent kammer til anvendelse i mus for at undersøge opførslen af mikro-implantater af tumorceller 12. På grund af den kendsgerning, at mus er såkaldte løse hud dyr og efter nogle tekniske forbedringer i de følgende år Lehr og medarbejdere var i stand til at tilpasse sig en sådan en dorsal skinfold kammer udvikle en mindre og lettere titanium kammer. Dette kammer aktiveret evaluering under anvendelse af intravital fluorescensmikroskopi, en teknik, der giver mulighed for direkte og gentagne visualisering af et antal morfologiske og mikrocirkulatoriske funktioner og deres ændringer over tid under forskellige fysiologiske og patofysiologiske tilstande, såsom iskæmi-reperfusionsskade 13. I undersøgelsen af ​​perfusion af hud, muskler og knogler flaps under normale og patologiske tilstande to tendenser opstod: For det første de &quot;akutte&quot; klap-modeller, der ikke bruger den dorsale skinfold kammer såsom pedicled øre klap i musen 14, sideværts baseret ø hudlap den i hamster 15 og pedicled sammensatte klap i rotten 16. Sekund, &quot;kronisk&quot; flap model, hvor kombinationen af ​​en klap med en dorsal skinfold chamber tillader gentagne mikrocirkulatorisk analyser over flere dage med intravital fluorescensmikroskopi. Den består af en tilfældigt perfunderet musculocutaneous flap, der er integreret i skinfold kammer af musen 17. Dens bredde-til-længde forholdet blev valgt således, at en situation med akut vedvarende iskæmi konsekvent resulterer i ~ 50% flap vævsnekrose 10 til 14 dage efter flap elevation. Denne reproducerbar omfanget af vævsnekrose tillader yderligere vurdering af begge, beskyttende (dvs. udvikling af less nekrose) og skadelige faktorer (dvs. udvikling af mere nekrose) på klap patofysiologi. I de seneste år har flere eksperimentelle publikationer viser virkningen af forskellige præ-, peri- og post-conditioning procedurer, herunder administration af vævs-beskyttende stoffer 18-24 og den lokale anvendelse af fysiologiske stressfaktorer såsom varme 25 og chokbølger 26, er dukket op. De kvantitative analyser af nekrose, mikrovaskulære morfologi og mikrocirkulatoriske parametre kan yderligere korreleret til immunohistokemiske analyser og protein assays. Forskellige proteiner og molekyler, herunder vaskulær endotel vækstfaktor (VEGF), nitrogenoxidsyntaser (NOS), nuklear faktor kappa B (NF-KB) og varmechokproteiner (HSP-32: hemoxygenase 1 (HO-1) og HSP- 70) er blevet vist at spille en rolle i vævsbeskyttelse. Baseret på dette kammer flap model, har to ændringer er udviklet i order til at analysere neovaskularisering og mikrocirkulationen under hudtransplantation healing 27 og angiogene udviklingen i en pedicled klap med aksial mønster perfusion 28. Vi præsenterer en reproducerbar og pålidelig model, der inkluderer en iskæmisk udfordret musculocutaneous klap i musen skinfold kammer. Denne model giver mulighed for visualisering og kvantificering af mikrocirkulationen og hæmodynamik ved intravital epi-fluorescens mikroskopi.

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		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">desinfection alcohol</td>
			<td style="width:244px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">Vicryl 5-0</td>
			<td style="width:244px;">Ethicon</td>
			<td style="width:119px;">V 490 H</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">Ethilon 5-0</td>
			<td style="width:244px;">Ethicon</td>
			<td style="width:119px;">EH 7823 H</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">1ml syringes</td>
			<td style="width:244px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">surgical skin marker with flexible ruler</td>
			<td style="width:244px;">Purple surgical</td>
			<td>PS3151</td>
			<td>any surgical skin marker and flexible ruler</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;"></td>
			<td style="width:244px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">pointed scissors</td>
			<td style="width:244px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">Micro-Scissors</td>
			<td style="width:244px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">normal scissors</td>
			<td style="width:244px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">2 clamps</td>
			<td style="width:244px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">fine anatomic forceps</td>
			<td style="width:244px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">micro-forceps</td>
			<td style="width:244px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;"></td>
			<td style="width:244px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">hex nuter driver</td>
			<td style="width:244px;">wiha</td>
			<td>1018</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">screwdriver</td>
			<td style="width:244px;">wiha</td>
			<td style="width:119px;">685</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">snap ring plier</td>
			<td style="width:244px;">Knipex</td>
			<td style="width:119px;">4411J1</td>
			<td>12-25mm</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">wire cutter</td>
			<td style="width:244px;">Knipex</td>
			<td style="width:119px;">70 02 160</td>
			<td>Wire cutter is used to cut screws short; 160mm</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;"></td>
			<td style="width:244px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">trans-illumination light</td>
			<td style="width:244px;">IKEA</td>
			<td>501.632.02</td>
			<td>LED light Jansj&#246;; any light&#160;</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">magnification glasses</td>
			<td style="width:244px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;"></td>
			<td style="width:244px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">intravital microscope</td>
			<td style="width:244px;">Zeiss</td>
			<td>490035-0001-000</td>
			<td>Scope.A1.Axiotech</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">LED system</td>
			<td style="width:244px;">Zeiss</td>
			<td>423052-9501-000</td>
			<td>Colibri.2</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">LED module 365nm</td>
			<td style="width:244px;">Zeiss</td>
			<td>423052-9011-000</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">LED module 470nm</td>
			<td style="width:244px;">Zeiss</td>
			<td>423052-9052-000</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">LED module 540-580nm</td>
			<td style="width:244px;">Zeiss</td>
			<td>423052-9121-000</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">Filter set 62 62 HE BFP + GFP + HcRed</td>
			<td style="width:244px;">Zeiss</td>
			<td>489062-9901-000</td>
			<td>range 1: 350-390nm excitation wavelength split 395 / 402-448nm; range 2: 460-488nm, split 495nm / 500-557nm; range 3: 567-602nm, split 610nm / 615-infinite</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">Filter set 20 Rhodamine</td>
			<td style="width:244px;">Zeiss</td>
			<td>485020-0000-000</td>
			<td>540-552nm, split 560, emission 575-640nm</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">2,5x objective NA=0,06</td>
			<td style="width:244px;">Zeiss</td>
			<td>421020-9900-000</td>
			<td>A-Plan 2,5x/0.06</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">5x objective NA=0,16</td>
			<td style="width:244px;">Zeiss</td>
			<td>420330-9901-000</td>
			<td>EC Plan-Neofluar 5x/0.16 M27</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">10x objetive NA=0,30</td>
			<td style="width:244px;">Zeiss</td>
			<td>420340-9901-000</td>
			<td>EC Plan-Neofluar 10x/0.30 M27</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">20x objective NA=0.50</td>
			<td style="width:244px;">Zeiss</td>
			<td>420350-9900-000</td>
			<td>EC Plan-Neofluar 20x/0.50 M27</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">50x objective NA=0,55</td>
			<td style="width:244px;">Zeiss</td>
			<td>422472-9960-000</td>
			<td>LD Epiplan-Neofluar 50x/0.55 DIC 27</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;"></td>
			<td style="width:244px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">ZEN imaging software</td>
			<td style="width:244px;">Zeiss</td>
			<td style="width:119px;"></td>
			<td>ZenPro 2012</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">CapImage</td>
			<td style="width:244px;">Dr. Zeintl</td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;"></td>
			<td style="width:244px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">Fluorescein isothiocyanate-dextran</td>
			<td style="width:244px;">Sigma-Aldrich</td>
			<td style="width:119px;">45946</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">bisBenzimide H 33342 trihydrochloride</td>
			<td style="width:244px;">Sigma-Aldrich</td>
			<td style="width:119px;">B2261</td>
			<td>harmful if swallowed; causes severe skin burns and eye damage, may cause repiratory irritat</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">Rhodamine 6G chloride</td>
			<td style="width:244px;">Invitrogen</td>
			<td style="width:119px;">R634</td>
			<td>harmful if swallowed; may cause genetic defects; may cause cancer; may damage fertility or the unborn child</td>
		</tr>
		<tr height="22">
			<td height="22" style="height:22px;width:319px;"></td>
			<td style="width:244px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:319px;">Pentobarbital</td>
			<td style="width:244px;">Merial</td>
			<td style="width:119px;"></td>
			<td>Narcoren&#174;</td>
		</tr>
	</tbody>
</table>

ischemic tissue injury in the dorsal skinfold chamber of the mouse: a skin flap model to investigate acute persistent ischemia

Trods dyb ekspertise og avancerede kirurgiske teknikker er iskæmiinduceret komplikationer lige fra sår nedbrydning omfattende vævsnekrose stadig forekommer, især i rekonstruktiv flap kirurgi. Flere eksperimentelle flap modeller er blevet udviklet til at analysere de underliggende årsager og mekanismer og til at undersøge behandlingsstrategier for at forebygge iskæmiske komplikationer. Den begrænsende faktor i de fleste modeller er den manglende mulighed for direkte og repetitivt visualisere mikrovaskulær arkitektur og hæmodynamik. Målet med protokollen var at præsentere en veletableret musemodel affilierede disse før nævnte mangler elementer. Harder et al. Har udviklet en model af en musculocutaneous klap med en tilfældig perfusion mønster, som gennemgår akut vedvarende iskæmi og resulterer i ~ 50% nekrose efter 10 dage, hvis de holdes ubehandlet. Ved hjælp af intravital epi-fluorescens mikroskopi, dette kammer model muliggør gentagne visualisering afmorfologi og hæmodynamik i forskellige regioner af interesse over tid. Associerede processer, såsom apoptose, inflammation, mikrovaskulær lækage og angiogenese kan undersøges og korreleres til immunohistokemiske og molekylære protein assays. Til dato har den model bevist gennemførlighed og reproducerbarhed i flere publicerede eksperimentelle studier, der undersøger effekten af ​​præ-, peri- og postconditioning af iskæmisk udfordret væv.

Necrosis
The main endpoint of this model&#160;&#8212; tissue necrosis following flap elevation (i.e., induction of acute persistent ischemia) &#8212; is repeatedly measured and illustrated macroscopically as shown in Figure 3 over a period of 10 days. Final demarcation of flap necrosis usually occurs between day 5 and 7 after surgery and is characterized by a red fringe, i.e., zone of vasodilation and microvascular remodeling, developing betw...

Watch this Scientific Journal Video about Ischemic Tissue Injury in the Dorsal Skinfold Chamber of the Mouse: A Skin Flap Model to Investigate Acute Persistent Ischemia at JoVE.com

Ischemic Tissue Injury in the Dorsal Skinfold Chamber of the Mouse: A Skin Flap Model to Investigate Acute Persistent Ischemia

The window of the murine dorsal skinfold chamber presented visualizes a zone of acute persistent ischemia of a musculocutaneous flap. Intravital epi-fluorescence microscopy permits for direct and repetitive assessment of the microvasculature and quantification of hemodynamics. Morphologic and hemodynamic results can further be correlated with histological and molecular analyses.

Iskæmisk væv skade i Dorsal hudfolden Afdeling Mus: En hudlap modellen til Akut Persistent Iskæmi

Despite profound expertise and advanced surgical techniques, ischemia-induced complications ranging from wound breakdown to extensive tissue necrosis are ...

Research

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Medicine

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In situ Transverse Rectus Abdominis Myocutaneous Flap: A Rat Model of Myocutaneous Ischemia Reperfusion Injury

In situ Tværgående Rectus abdominis Myocutaneous Flap: En Rat Model of Myocutaneous iskæmisk reperfusionsbeskadigelse

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Acute or chronic myocardial infarction (MI) are cardiovascular events resulting in high morbidity and mortality. Establishing the pathological mechanisms ...

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Ischemia-reperfusion injury (IRI) occurs when there is transient hypoxia due to the obstruction of blood flow (ischemia) followed by a subsequent ...

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Scratch migration assay og dorsale Skinfold kammer for in vitro og in vivo analyse af sårheling

Impaired cutaneous wound healing is a major concern for patients suffering from diabetes and for elderly people, and there is a need for an effective ...

A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery

En præklinisk rotte model for studiet af iskæmi-reperfusion skade i rekonstruktiv mikrokirurgi

Ischemia-reperfusion injury is the main cause of flap failure in reconstructive microsurgery. The rat is the preferred preclinical animal model in many ...