Evidence map›Paper›PMID 42162399›Full record

ArticleLab animal2026

Evaluating perfusion and metabolic responses of microvascular free flaps to ischemia, reperfusion and fluid resuscitation during septic shock in a large animal model.

Daniel Stephan, Alexander Ziebart, Robert Ruemmler, Miriam Renz, Bilal Al-Nawas, Sebastian Blatt, Peer W Kämmerer, Daniel G E Thiem

Abstract read
In one paragraph

Article in Lab animal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Daniel StephanDepartment of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany. stephand@uni-mainz.de.ORCID http://orcid.org/0009-0007-2480-1231
Alexander ZiebartDepartment of Anaesthesiology, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Robert RuemmlerDepartment of Anaesthesiology, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Miriam RenzDepartment of Anaesthesiology, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Bilal Al-NawasDepartment of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Sebastian BlattDepartment of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Peer W KämmererDepartment of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Daniel G E ThiemDepartment of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.ORCID http://orcid.org/0000-0002-4081-1487

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Microvascular free flap transfer is an essential procedure in head and neck reconstructive surgery, with total flap loss representing the primary complication. Sepsis has been identified as a critical risk factor contributing to flap failure. Here we aimed to evaluate the impact of septic shock on free flap vitality using a large animal model and further investigated the flap-specific effects of different fluid resuscitation strategies on flap viability and metabolic response. A prospective, randomized trial was conducted on 31 juvenile male pigs to assess the effects of 3 fluid resuscitation strategies following septic shock induced by lipopolysaccharide infusion. The strategies included a balanced crystalloid solution, a colloid, and a combination of crystalloid and resveratrol. Free flap vitality was continuously monitored using hyperspectral imaging and blood gas analysis, comparing intraflap venous blood with central venous blood. The crystalloid group most effectively maintained higher oxygen saturation and lower lactate levels. Conversely, the colloid group exhibited lower tissue oxygen saturation and higher lactate levels. The combination of crystalloid and resveratrol stabilized the hemoglobin and tissue water indices. The study demonstrated a significant influence of different fluid resuscitation strategies on metabolic and perfusion outcomes of free flaps under septic conditions. Administration of crystalloid suggests optimized oxygen delivery and utilization, whereas the combination with resveratrol provided an improved balance of blood volume and hydration, hence preventing fluid overload.

Indexed as

Fluid TherapyFree Tissue FlapsReperfusion InjuryResuscitationShock, SepticAnimalsCrystalloid SolutionsDisease Models, AnimalIsotonic SolutionsMaleRandom AllocationResveratrolSwineCrystalloid SolutionsIsotonic SolutionsResveratrol

Identifiers

PMID42162399
PMCPMC13421353

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.