Transferencia tisular libre en microcirugía reconstructivaempleo de terapia celular para modular el daño por isquemia-reperfusión en colgajos cutáneos

Resumo

Microsurgery has become a common surgical technique in the field of reconstructive surgery. Free tissue transfers provides an efficient approach to restore multiple defects caused by burns, trauma injuries or after oncological resections. A period of tissue ischemia is associated in all free flaps and a proper assessment of the microsurgical anastomoses is essential for these surgical procedures. For this purpose, different methods of blood flow measurement are gaining interest among clinicians and researchers. Despite obtaining optimal functioning of the microsurgical anastomoses, after a long-time period of ischemia, there is an important tissue damage that is augmented after reperfusion. This tissue damage may lead a failure in the surgical procedure. Stem cell therapy is an emerging therapeutic tool for the treatment of various pathologies, its anti-inflammatory and pro-regenerative effects may be of interest in the reconstructive field. This doctoral thesis aims to evaluate therapeutic strategies in the field of reconstructive microsurgery. Each of these strategies constitutes different PhD chapters. The first chapter focuses on the evaluation of microsurgical anastomoses through the use of vascular flow measurement equipment based on transit-time ultrasound technology. The second chapter focuses on the study of ischemia-reperfusion injury in an animal model under controlled conditions. Moreover, stem cell based therapies were performed to modulate the associated tissue damage. The third chapter focuses on the study of vascularized lymph node transfer (VLNT) for the restoration of lymphatic drainage as a therapeutic option for the treatment of lymphedema.