DOI: 10.5068/d14h3m
title: Tumescent injections in subcutaneous pig tissue disperse fluids volumetrically and maintain elevated local concentrations of additives for several hours, suggesting a treatment for drug resistant wounds

description: Purpose Bolus injection of fluid into subcutaneous tissue results in
 accumulation of fluid at the injection site. The fluid does not form a
 pool. Rather, the injection pressure forces the interstitial matrix to
 expand to accommodate the excess fluid in its volume, and the fluid
 becomes bound similar to that in a hydrogel. We seek to understand the
 properties and dynamics of externally tumesced (swollen) subcutaneous
 tissue as a first step in assessing whether tumescent antibiotic
 injections into wounds may provide a novel method of treatment. Methods
 Subcutaneous injections of saline are performed in live and dead pigs and
 the physical properties (volume, expansion ratio, residence time, apparent
 diffusion constant) of the resulting fluid deposits are observed with
 diffusion-weighted magnetic resonance imaging, computed tomography, and 3D
 scanning. Results Subcutaneous tissue can expand to a few times its
 initial volume to accommodate the injected fluid, which is dispersed
 thoroughly throughout the tumescent volume. The fluid spreads to
 peripheral unexpanded regions over the course of a few minutes, after
 which it remains in place for several hours. Eventually the circulation
 absorbs the excess fluid and the tissue returns to its original state.
 Conclusions Given the evidence for dense fluid dispersal and several-hour
 residence time, a procedure is proposed whereby tumescent antibiotic
 injections are used to treat drug-resistant skin infections and chronic
 wounds that extend into the subcutaneous tissue. The procedure has the
 potential to effectively treat otherwise untreatable wounds by keeping
 drug concentrations above minimum inhibitory levels for extended lengths
 of time.
description: The experiments and methods are described in detail in the
 article "Tumescent Injections in Subcutaneous Pig Tissue Disperse
 Fluids Volumetrically and Maintain Elevated Local Concentrations of
 Additives for Several Hours, Suggesting a Treatment for Drug Resistant
 Wounds" [http://dx.doi.org/10.1007/s11095-020-2769-2], and its
 supplementary material.  Data provided is unprocessed.
description: Five data sets imaging the physical properties of pig
 subcutaneous tissue that has been tumesced with saline.  Analysis of the
 data is presented in the article "Tumescent Injections in
 Subcutaneous Pig Tissue Disperse Fluids Volumetrically and Maintain
 Elevated Local Concentrations of Additives for Several Hours, Suggesting a
 Treatment for Drug Resistant Wounds"
 [http://dx.doi.org/10.1007/s11095-020-2769-2]. 1) MRI
 and Diffusion-Weighted MRI data on the size and apparent diffusion
 coefficient of pig subcutaneous tissue infused with 0-40 mL saline.  Files
 are in DICOM format. 2) CT data on the evolution of
 2.5-20 mL saline injections into the subcutaneous tissue of a pig's
 abdomen on timescales 0-60 minutes.  Files are in DICOM format.
 3) CT data on the evolution of 2.5-20 mL saline injections into
 the subcutaneous tissue of a pig's abdomen on timescales 0-7
 hours.  Files are in DICOM format. 4) CT data on the
 evolution of 2.5-20 mL saline injections, with added epinephrine, into the
 subcutaneous tissue of a pig's abdomen on timescales 0-7
 hours.  Files are in DICOM format. 5) 3D scans of a
 minipig's skin surface before and at several times after injection
 with 20 mL saline, over a time period of 0-20 minutes.  Files are in .obj
 format.