未经授权:虽然是自然现象,衰老是一种退行性疾病,可促进细胞功能障碍以及随后的器官和身体功能障碍。根据世界卫生组织,老年人是全球增长最快的年龄组。2012年的一份人口报告指出,4310万65岁或以上的成年人居住在美国,预计到2050年将跃升至8370万,给本已捉襟见肘的医疗保健网络带来额外负担。老年患者广泛影响我们的医疗保健系统,正如2014年的伤口报告所报道的那样。820万患者被诊断患有至少一种类型的伤口,75岁或以上的患者构成了大部分的诊断。老化影响伤口愈合级联的所有阶段。虽然老年人的伤口愈合被下调,关于该组中衰老和皮瓣存活的影响的信息很少。因此,本研究旨在报道年龄对小鼠模型皮瓣存活的影响。我们假设年龄增加的动物会降低皮瓣的存活率。
UNASSIGNED:在系统评价和荟萃分析的首选报告项目之后,于2022年2月1日进行了系统评价。我们搜索了用英语写的全文文章,由实验小鼠模型组成,比较了老年和年轻动物的皮瓣存活率,在以下数据库中:PubMed,Scopus,CINAHL,和WebofScience。术语“小鼠”或“大鼠”和“手术皮瓣”和“衰老”指导我们的搜索。受慢性疾病影响的模型从研究中排除。
UNASSIGNED:在我们搜索的208篇文章中,根据我们的纳入和排除标准,纳入了7例.五项研究使用大鼠作为实验模型,而其余两只用的是老鼠。在五项研究中进行了局部皮瓣,和两个自由皮瓣,将它们从年轻和年老的动物转移到年轻的对照。五篇文章报道了老年组暴露于缺血性损伤时皮瓣存活率较低。三篇论文报道了血管生成的缺陷,血管生成,血管反应性是缺乏生存的合理原因,与一位作者关联并验证他们在人类受试者中的结果。尽管有一篇文章报道缺乏统计能力,他们认为趋势与以前的研究相似。最后,一篇文章报道了不确定和可变的结果。
UNASSIGNED:证据表明,缺乏血管生成和血管生成反应以及血管反应性降低是造成老年人皮瓣存活率降低的原因。增强血管生成的治疗手段,血管生成,和血管反应性以改善患者的预后需要进一步研究以了解老年人皮瓣存活的时程和机制。
UNASSIGNED:所有人类都会以某种方式感受到衰老的影响。然而,我们都同意衰老会影响我们的基本生物过程,这会对宏观外观产生负面影响。在老年人中下调的一个重要方面是他们对组织损伤和缺氧的反应能力,创造不利于伤口愈合的环境。此外,为了处理这些无法愈合的伤口,襟翼被抬起以形成覆盖这些缺陷。然而,年龄也会影响这些皮瓣的生存能力,加剧问题,进入恶性循环。为了改善结果,我们未来的研究必须集中在了解衰老如何影响老年人皮瓣存活的基本原理上。
UNASSIGNED: Although a natural phenomenon, aging is a degenerative condition that promotes cellular malfunction and subsequent organ and body dysfunction. According to the World Health Organization, the elderly are the fastest growing age group worldwide. A 2012 population report stated that 43.1 million adults of 65 years or older lived in the United States, which is expected to jump to 83.7 million in 2050, placing an additional burden on an already stretched health-care network. Elderly patients broadly impact our health-care system, as reported in a 2014 wound report. 8.2 million patients were diagnosed with at least one type of wound, with patients 75 years or older making up most of the diagnoses. Aging affects all stages of the wound healing cascade. Although wound healing is downregulated in the elderly, scarce information exists regarding the effects of aging and flap survival in this group. Therefore, this study aims to report the impact of age on the survival of
flaps in murine models. We hypothesize that increased aged animals will have decreased flap survival.
UNASSIGNED: A systematic
review was performed on February 1, 2022, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. We searched for full-text articles written in English, consisting of experimental murine models that compared flap survival between aged and young animals, in the following databases: PubMed, Scopus, CINAHL, and Web of Science. The terms \"mice\" OR \"rats\" AND \"surgical
flaps\" AND \"aging\" guided our search. Models affected by chronic diseases were excluded from the study.
UNASSIGNED: Out of the 208 articles found by our search, seven were included according to our inclusion and exclusion criteria. Five studies used rats as experimental models, while the remaining two used mice. Local
flaps were done in five studies, and two performed free
flaps, transferring them from young and aged animals to young controls. Five articles reported lower flap survival in elder groups when exposed to ischemic insults. Three papers reported a deficiency in angiogenesis, vasculogenesis, and vascular reactivity as plausible causes for lack of survival, with one author correlating and verifying their results in human subjects. Although one article reported a lack of statistical power, they perceived a trend similar to the previous studies. Finally, one article reported inconclusive and variable results.
UNASSIGNED: Evidence suggests that a lack of angiogenic and vasculogenic response in conjunction with decreased vascular reactivity are responsible for the diminished survival of flaps in the elder. Therapeutic means to boost the angiogenic, vasculogenic, and vascular reactivity response to improve patient outcomes require further research to understand the time course and mechanisms of flap survival in the elderly.
UNASSIGNED: All humans will feel the effects of aging one way or another. However, we can all agree that aging affects our basic biological processes, which negatively affects macroscopic appearance. One of the essential aspects downregulated in the elderly is their ability to respond to tissue injury and hypoxia, creating non-favorable circumstances for wound healing. Furthermore, to manage these non-healing wounds, flaps are raised to create a covering for these defects. However, age also impacts the ability of these
flaps to survive, augmenting the problem and entering a vicious circle. To improve outcomes, we must focus our future research on understanding the basic principles of how aging affects the survival of flaps in elderly population.