High cut-off microdialysis catheters to clinically investigate cytokine changes following flap transfer

Tollan, C. J., MacFarlane, N. G. and MacKay, I. R. (2021) High cut-off microdialysis catheters to clinically investigate cytokine changes following flap transfer. European Journal of Plastic Surgery, 44, pp. 483-492. (doi: 10.1007/s00238-020-01778-x)

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Background: ‘Choke vessels’ are thought to dilate in the first 72 h when blood flow to an area is disrupted. This study used ‘high cut-off’ microdialysis catheters in clinical research to investigate factors mediating circulatory change within free flaps. Methods: Six patients undergoing DIEP flap breast reconstruction each had three ‘high cut-off’ microdialysis catheters, with a membrane modification allowing molecules as large as 100 kDa to pass, inserted into Hartrampf zones 1, 2 and 4 to assess multiple vascular territories. Microdialysis continued for 72 h post-operatively. Samples were analysed for interleukin-6 (IL-6), tumour necrosis factor alpha (TNFα) and fibroblast growth factor basic (FGFβ). Results: Three hundred and twenty-four samples were analysed for IL-6, FGFβ and TNFα totalling 915 analyses. IL-6 showed an increasing trend until 36 h post-operatively before remaining relatively constant. Overall, there was an increase (p < 0.001) over the time period from 4 to 72 h, fitting a linear trend. TNFα had a peak around 20–24 h before a gradual decrease. There was a significant linear time trend (p = 0.029) between 4 and 76 h, decreasing over the time period. FGFβ concentrations did not appear to have any overall difference in concentration with time. The concentration however appeared to oscillate about a horizontal trend line. There were no differences between the DIEP zones in concentrations of cytokines collected. Conclusion: This study uses high-cut off microdialysis catheters to evaluate changes in cytokines, and requires further research to be undertaken to add to our knowledge of choke vessels and flap physiology.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Tollan Sivarajan, Ms Clare and MacFarlane, Professor Niall
Authors: Tollan, C. J., MacFarlane, N. G., and MacKay, I. R.
College/School:College of Medical Veterinary and Life Sciences > School of Life Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:European Journal of Plastic Surgery
ISSN (Online):1435-0130
Published Online:18 January 2021
Copyright Holders:Crown Copyright © 2021
First Published:First published in European Journal of Plastic Surgery 44: 483-492
Publisher Policy:Reproduced under a Creative Commons licence

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