Ischemia‐reperfusion injury in chronic pressure ulcer formation: A skin model in the rat

Most animal models of chronic pressure ulcers were designed to study only the role of ischemic injury in wound formation, often using single applications of constant pressure. The purpose of this study was to develop and characterize a reproducible model of cyclic ischemia‐reperfusion injury in the skin of small un‐anesthetized animals using clinically relevant pressures and durations. Ischemia‐reperfusion injury was created in a 9 cm2 region of dorsal skin in male rats by periodically compressing skin under a pressure of 50 mm Hg using an implanted metal plate and an overlying magnet. We varied the total number of ischemia‐reperfusion cycles, examined the effect of varying the frequency and duration of ischemic insult, and compared ischemia‐induced injury to ischemia‐reperfusion‐induced injury with this model. Tissue injury increased with an increasing number of total ischemia‐reperfusion cycles, duration of ischemia, and frequency of ischemia‐reperfusion cycles. This model generates reproducible ischemia‐reperfusion skin injury as characterized by tissue necrosis, wound thickness, leukocyte infiltration, transcutaneous oxygen tension, and wound blood flow. Using this model, the biological markers of ischemia‐reperfusion‐induced wound development can be studied and therapeutic interventions can be evaluated in a cost‐effective manner.

[1]  P. Kubes Nitric Oxide Affects Microvascular Permeability in the Intact and Inflamed Vasculature , 1995, Microcirculation.

[2]  R Schosser,et al.  Histopathology of pressure ulcers as a result of sequential computer-controlled pressure sessions in a fuzzy rat model. , 1994, Advances in wound care : the journal for prevention and healing.

[3]  A. Jakobsson Sampling depth in Laser Doppler flowmetry , 1992 .

[4]  Keith J. Leland,et al.  Temperature-modulated pressure ulcers: a porcine model. , 1995, Archives of physical medicine and rehabilitation.

[5]  W J Quinones-Baldrich,et al.  Reperfusion injury. , 1991, Critical care nursing clinics of North America.

[6]  S M Dinsdale,et al.  Decubitus ulcers: role of pressure and friction in causation. , 1974, Archives of Physical Medicine and Rehabilitation.

[7]  R. Woolfson,et al.  Ischaemia and reperfusion injury in the kidney: current status and future direction. , 1994, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[8]  M. Kosiak,et al.  Etiology and pathology of ischemic ulcers. , 1959, Archives of physical medicine and rehabilitation.

[9]  D. Granger,et al.  Leukocyte adhesion in local versus hemorrhage-induced ischemia. , 1992, The American journal of physiology.

[10]  A. Nakao,et al.  Mechanism and prevention of ischemia-reperfusion injury of the liver. , 1996, Seminars in surgical oncology.

[11]  W. Swartz,et al.  The causes of skin ulcerations associated with venous insufficiency: a unifying hypothesis. , 1987, Plastic and reconstructive surgery.

[12]  J. Soulillou,et al.  The role of adhesion molecules in ischaemia-reperfusion injury of renal transplants. , 1997, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[13]  R. Daniel,et al.  Etiologic factors in pressure sores: an experimental model. , 1981, Archives of physical medicine and rehabilitation.

[14]  E. Pretto Reperfusion injury of the liver. , 1991, Transplantation proceedings.

[15]  R. A. Roberts Pressure Ulcers in Adults: Prediction and Prevention, Clinical Practice Guidelines, Number 3. AHCPR Publication No. 92–0047 , 1994 .

[16]  R. Whittemore,et al.  Pressure-reduction support surfaces: a review of the literature. , 1998, Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society.

[17]  J. Carney,et al.  An animal model and computer-controlled surface pressure delivery system for the production of pressure ulcers. , 1995, Journal of rehabilitation research and development.

[18]  J. Sanders,et al.  Skin response to repetitive mechanical stress: a new experimental model in pig. , 1998, Archives of physical medicine and rehabilitation.

[19]  R. Hobson,et al.  Microvascular transport and endothelial cell alterations preceding skeletal muscle damage in ischemia and reperfusion injury. , 1987, American journal of surgery.