External Volume Expansion in Irradiated Tissue: Effects on the Recipient Site
Authors
Chin, Michael S.Lujan-Hernandez, Jorge
Babchenko, Oksana Olegovna
Bannon, Elizabeth
Perry, Dylan
Chappell, Ava G.
Lo, Yuan-Chyuan
Fitzgerald, Thomas J.
Lalikos, Janice F.
Faculty Advisor
Janice Lalikos, MDUMass Chan Affiliations
Senior Scholars ProgramSchool of Medicine
Department of Surgery, Division of Plastic Surgery
Department of Radiation Oncology
Document Type
Journal ArticlePublication Date
2016-05-01
Metadata
Show full item recordAbstract
BACKGROUND: External volume expansion prepares recipient sites to improve outcomes of fat grafting. For patients receiving radiotherapy after mastectomy, results with external volume expansion vary, and the relationship between radiotherapy and expansion remains unexplored. Thus, the authors developed a new translational model to investigate the effects in chronic skin fibrosis after radiation exposure. METHODS: Twenty-four SKH1-E mice received 50 Gy of beta-radiation to each flank and were monitored until fibrosis developed (8 weeks). External volume expansion was then applied at -25 mmHg to one side for 6 hours for 5 days. The opposite side served as the control. Perfusion changes were assessed with hyperspectral imaging. Mice were euthanized at 5 (n = 12) and 15 days (n = 12) after the last expansion application. Tissue samples were analyzed with immunohistochemistry for CD31 and Ki67, Masson trichrome for skin thickness, and picrosirius red to analyze collagen composition. RESULTS: All animals developed skin fibrosis 8 weeks after radiotherapy and became hypoperfused based on hyperspectral imaging. Expansion induced edema on treated sides after stimulation. Perfusion was decreased by 13 percent on the expansion side (p < 0.001) compared with the control side for 5 days after stimulation. Perfusion returned to control-side levels by day 15. Dermal vasculature increased 38 percent by day 15 (p < 0.01) in expansion versus control. No difference was found in collagen composition. CONCLUSIONS: External volume expansion temporarily reduces perfusion, likely because of transient ischemia or edema. Together with mechanotransduction, these effects encourage a proangiogenic and proliferative environment in fibrotic tissue after radiotherapy in the authors' mouse model. Further studies are needed to assess these changes in fat graft retention.Source
Plast Reconstr Surg. 2016 May;137(5):799e-807e. doi: 10.1097/PRS.0000000000002081. Link to article on publisher's siteDOI
10.1097/PRS.0000000000002081Permanent Link to this Item
http://hdl.handle.net/20.500.14038/49305PubMed ID
27119942Notes
Oksana Babchenko, Dylan Perry, and Ava Chappell participated in this study as medical students as part of the Senior Scholars research program at the University of Massachusetts Medical School.
Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1097/PRS.0000000000002081