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Gender-specific ischemic tissue tolerance in critically perfused skin

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Abstract

Purpose

The purpose of this study is to determine gender-specific differences in the development of necrosis in persistent ischemic tissue and to analyze whether differences are due to gender-specific loss of vascular reactivity or change in ischemic tolerance.

Methods

Hairless mice (skh-1) of both genders were assigned to three groups of adolescent, adult, and senescent age. Critical ischemia was induced by transection of the two distal pedicles of the animal’s ear. Microcirculation was assessed over a 5-day period using intravital epifluorescence microscopy. Tissue necrosis, blood flow, functional capillary density (FCD), red blood cell (RBC) velocity, and capillary diameter were analyzed.

Results

Induction of persistent ischemia caused an age-dependent demarcation of nonperfused flap tissue. Adult and senescent females developed markedly more necrosis than age-matched males (49 ± 1% vs. 37 ± 3% and 53 ± 3% vs. 44 ± 2%, respectively; p < 0.05), whereas no gender-specific difference in flap necrosis was observed in adolescent animals (31 ± 2% vs. 33 ± 3%). Gender did not affect the amount of microcirculatory dysfunction in the flap. Thus, age-matched females and males exhibited a comparable decrease of FCD, RBC velocity, and capillary dilatory response.

Conclusions

Both age and female gender may predispose for an increased susceptibility to develop ischemic tissue necrosis. The increased necrosis in female animals does not apply to an aggravated microvascular dysfunction, but rather to a reduced ischemic tissue tolerance.

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Acknowledgements

Y. H. is a recipient of a fellowship of the Swiss National Science Foundation (SNF-No. PBBSB-102601), the “Freiwillige Akademische Gesellschaft” (FAG), and the “Margarete und Walter Lichtenstein Stiftung, Medical Department” in Basel, Switzerland.

Conflict of interest

None of the authors has any conflict of interest with the present study.

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Authors and Affiliations

  1. Institute for Clinical and Experimental Surgery, University of Saarland, Homburg, Saarland, Germany

    Yves Harder, Michaela Amon, René Schramm & Michael D. Menger

  2. Division of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, CH-1211, Geneva, Switzerland

    Yves Harder & Reto Wettstein

  3. Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany

    Martin Rücker

Authors
  1. Yves Harder
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  2. Michaela Amon
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  3. Reto Wettstein
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  4. Martin Rücker
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  5. René Schramm
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  6. Michael D. Menger
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Correspondence to Yves Harder.

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Harder, Y., Amon, M., Wettstein, R. et al. Gender-specific ischemic tissue tolerance in critically perfused skin. Langenbecks Arch Surg 395, 33–40 (2010). https://doi.org/10.1007/s00423-009-0558-9

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  • DOI: https://doi.org/10.1007/s00423-009-0558-9

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