Improved skin flap survival after local heat preconditioning in pigs

Preconditioning induces the expression of heat shock proteins (HSPs), which can help a cell survive an acute episode of stress. Similar to the induction of HSP expression, the cell protection is independent of the type of stress. The aim of this study was to test in a large, randomized animal model,...

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Bibliographic Details
Published in:The Journal of surgical research 2004-06, Vol.119 (1), p.100-105
Main Authors: HARDER, Y, CONTALDO, C, KLENK, J, BANIC, A, JAKOB, S. M, ERNI, D
Format: Article
Language:English
Subjects:
Animals
Apoptosis
Biological and medical sciences
Conditioning (Psychology)
General aspects
Hot Temperature
HSP70 Heat-Shock Proteins - metabolism
Immunohistochemistry
In Situ Nick-End Labeling
Medical sciences
Necrosis
Skin - metabolism
Skin - pathology
Skin - physiopathology
Surgical Flaps
Swine
Tissue Survival
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Summary:Preconditioning induces the expression of heat shock proteins (HSPs), which can help a cell survive an acute episode of stress. Similar to the induction of HSP expression, the cell protection is independent of the type of stress. The aim of this study was to test in a large, randomized animal model, if skin flap survival may be improved by local heat preconditioning and induction of HSP 70. Twenty-four hours before surgery, a heating blanket was laid on the buttocks of large white pigs. In the preconditioned group (n = 6), the blanket was warmed up to 43 degrees C for 3 x 30 min, whereas it was kept at room temperature in between the heating episodes as well as in the control animals (n = 6). A random pattern skin flap was raised on both sides of the buttocks. Flap survival was measured clinically. Induction of HSP and apoptosis were assessed quantitatively by immunohistochemistry and TUNEL assay, respectively. Preconditioning reduced flap necrosis from 40 +/- 8% of the total flap surface to 7 +/- 14% (P < 0.01). Induction of HSP was significantly higher in the experimental group (79 +/- 12% versus 42 +/- 13%, P < 0.01), whereas apoptosis in healthy flap tissue was reduced from 30 +/- 11 to 11 +/- 6 cells/visual field (P < 0.01). In the present study, necrosis and apoptosis rate of skin flaps could be reduced significantly due to local heat preconditioning. Our results suggest that ischemia-related wound healing complications could be diminished with local heat application, a most simple and least invasive method of preconditioning.
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2003.11.002