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J Reconstr Microsurg 2013; 29(02): 117-124
DOI: 10.1055/s-0032-1329924
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Microvascular Effects of Subatmospheric Pressure in Striated Muscle

Maxwell Langfitt
1   Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina
,
Lawrence X. Webb
2   Department of Orthopaedic Surgery, Mercer University School of Medicine, Macon, Georgia
,
Cheryl Onwuchuruba
3   Department of Orthopaedic Surgery, University of Tennessee School of Medicine, Knoxville, Tennessee
,
Michael Callahan
1   Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina
,
Thomas L. Smith
1   Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina
› Author Affiliations
Further Information

Publication History

01 July 2012

25 August 2012

Publication Date:
04 January 2013 (online)

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Abstract

Objective Topical application of subatmospheric pressure (TASAP) promotes faster wound healing, but tissue effects are not entirely understood. This study investigated microvascular effects of TASAP in striated muscle with the hypothesis being that TASAP elicits arteriolar vasodilation and decreases interstitial accumulation of protein.

Methods Rat cremasteric microcirculation was directly examined in two experiments utilizing a novel technique. First, TASAP was applied to the cremaster in three experimental groups and a non-TASAP control group. Arteriolar diameters were directly measured before and after TASAP. In experiment two, intravascular fluorescein isothiocyanate (FITC)-labeled albumin and topical leukotriene B4 (LTB4) were delivered to the cremaster. Microvascular permeability was assessed by measuring the accumulation/disappearance of FITC-albumin in the interstitial tissue.

Results TASAP produced significant arteriolar vasodilation compared with control values. The mean maximum percent increase in diameter with TASAP was 8.70% at −2 kPa (p < 0.05), 7.16% at −4 kPa (p < 0.05), and 10.43% at −6 kPa (p < 0.01). TASAP decreased interstitial FITC-albumin by 26.3% (p < 0.008) following LTB4; the control group showed a steady increase in interstitial FITC-albumin.

Conclusions These results support the hypothesis that TASAP elicits significant arteriolar vasodilation with a subsequent increase in blood flow as well as a decrease in interstitial protein accumulation.

Keywords

topical subatmospheric pressure - vasodilation - blood flow - vacuum-assisted closure - microvascular permeability

Note

Research performed at Wake Forest Baptist Medical Center, Department of Orthopaedic Surgery, Winston-Salem, NC 27157.


 

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