2990 Microsurgery.qxd - O'Brien Institute

Scientific Research
Bernard O’Brien Institute of Microsurgery
TRAUMA LABORATORY
L to R: Dr Kanit Sananpanich, Tanya Harkom, Dr Aurora Messina, Dr Ruitong Fan, Rosalind Romeo, Jon Davis, Dr Glykeria Pantazi and Scott Baker.
Members of the Laboratory:
J Barker, B Dowsing, T Harkom, J Hurley,
S Johnson, K Knight, B Lazarus, D Lepore,
A Messina, G Pantazi, W Morrison, R Romeo,
A Stewart, P Vadiveloo, M Wagh, G Willemart
and B Zhang.
... and Major Collaborators:
F Clay 2 , P Cowan 5 , M Ernst 2 , P Hertzog 1 ,
J Hamilton 3 , M Pearse 5 , T Shinkel 5 , A Tomasi 6
and G Vairo 4
1 Monash Medical Centre, Clayton, Vic.
2 Ludwig Institute for Cancer Research,
Parkville Vic.
3 University Dept of Medicine, Royal Melbourne
Hospital, Parkville.
4 Walter and Eliza Hall Institute, Univ Melbourne,
Parkville.
5 Immunology Research Centre, St Vincent’s
Hospital, Melbourne.
6 Universita degli Studi di Modena, Modena, Italy.
Trauma is injurious to tissues in many ways. In an
extreme case, tissue may be instantly destroyed.
Crush injury may result in swelling, bleeding and
contamination leading to partial destruction, but
with some potential for recovery.
In other circumstances it is specifically the blood
supply to tissues that is interrupted and when it
is not restored, death (necrosis) of the part will
ensue. Even if the circulation is restored the
toxic products that have accumulated in the
devascularised part will trigger an inflammatory
response in an attempt to prevent these toxins
causing harm to the body. This process is
known as the ischaemia-reperfusion (IR) injury
and it can cause death of the part despite a
‘successful’ revascularisation. This typically
occurs following replantation or tissue transfer
and is more severe the longer the part has been
detached from the body.
We have been investigating the mechanisms of
IR injury and techniques to minimise the damage
caused by this process. This research has direct
application to all microvascular reconstructive
procedures that are currently performed as well
as increasing the success rates of replantation. It
is vitally important in organ transplantation and
in reducing the damage caused by strokes and
heart attacks. In the future the research will
enable tissues to be preserved for prolonged
periods leading to ‘tissue banks’.
Tissue injury following ischaemiareperfusion
When blood flow to organs stops or is greatly
reduced, the nutritional requirements of the
tissues are not met after a period of a few
minutes. This causes ischaemic damage. When
blood flow resumes after a period of ischaemia,
more damage to the tissues occurs from the
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