Document Detail

Stimulation of angiogenesis to improve the viability of prefabricated flaps.
MedLine Citation:
PMID:  9529215     Owner:  NLM     Status:  MEDLINE    
The cutaneous area in a prefabricated myocutaneous flap surviving after elevation is dependent on the rate and amount of vascular ingrowth that occurs from the underlying muscle. Two modalities, basic fibroblast growth factor and hyperbaric oxygen, were used separately and together in a prefabricated myocutaneous flap animal model to improve flap survival. The semimembranous muscle, based on the saphenous vessels of 40 female Wistar rats weighing between 250 and 325 grams, was tunneled under the ipsilateral abdominal skin and sutured in place. A 3 x 5-cm silicone sheet was placed beneath the muscle flap, and the ipsilateral epigastric vessels were ligated. Four groups of 10 animals each received one of the following treatment regimes: a 1-ml normal saline infusion into the saphenous arterial pedicle, a 1-ml infusion of basic fibroblast growth factor (1.0 microg/gm of muscle), a 1-ml normal saline infusion and 14 hyperbaric oxygen treatments, or a 1-ml basic fibroblast growth factor infusion and 14 hyperbaric oxygen treatments. After 1 week, the muscle, still based on the saphenous vessels, was elevated with a 3 x 5-cm abdominal skin paddle. The flap was sutured back in place, leaving the silicone sheet intact. The surviving area of each flap was measured 1 week later after it had demarcated into viable and necrotic regions. Laser Doppler skin perfusion measurements were taken before and after flap elevation and before animal euthanasia. Sixteen flaps, 4 in each group, were examined histologically for vascularity by means of hematoxylin and eosin staining. There was a statistically significant increase in flap survival area when either basic fibroblast growth factor or hyperbaric oxygen was used alone. Further improvement was noted with combination therapy. Histology confirmed improved vascularity in the basic fibroblast growth factor and hyperbaric oxygen-treated flaps. This study shows a significant and reliable increase in the area of prefabricated myocutaneous flap survival using either basic fibroblast growth factor or hyperbaric oxygen. There is a further complementary effect when these two modalities are combined, leading to near complete flap survival through improved vascularity.
S Bayati; R C Russell; A C Roth
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  101     ISSN:  0032-1052     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  1998 Apr 
Date Detail:
Created Date:  1998-04-09     Completed Date:  1998-04-09     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1290-5     Citation Subset:  AIM; IM    
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MeSH Terms
Abdomen / surgery
Coloring Agents / diagnostic use
Disease Models, Animal
Eosine Yellowish-(YS) / diagnostic use
Epigastric Arteries / surgery
Fibroblast Growth Factor 2 / therapeutic use
Fluorescent Dyes / diagnostic use
Graft Survival* / drug effects
Hematoxylin / diagnostic use
Hyperbaric Oxygenation
Laser-Doppler Flowmetry
Muscle, Skeletal / blood supply,  pathology,  transplantation
Neovascularization, Physiologic / drug effects,  physiology*
Rats, Wistar
Reproducibility of Results
Saphenous Vein
Skin Transplantation / pathology
Sodium Chloride
Surgical Flaps / blood supply*,  pathology
Surgical Mesh
Reg. No./Substance:
0/Coloring Agents; 0/Fluorescent Dyes; 0/Silicones; 103107-01-3/Fibroblast Growth Factor 2; 7647-14-5/Sodium Chloride; TDQ283MPCW/Eosine Yellowish-(YS); YKM8PY2Z55/Hematoxylin

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