Necrosis of surgically transferred flaps due to ischemia is a serious wound problem. We evaluated the improvement of flap survival and changes in angiogenic gene expression profiles after transfer of the VEGF gene by means of adeno-associated virus type 2 (AAV2) vector to rat ischemic flaps. Thirty rats were divided into one experimental group, one AAV2-GFP group, and one saline group. AAV2-VEGF or AAV2-GFP were injected intradermally into the rat dorsum in the AAV2-VEGF or AAV2-GFP group. The saline group received saline injection. A 3 × 10 cm flap was raised in each rat two weeks post-injection. One week after surgery, flap viability was evaluated. Angiogenesis real-time PCR array was performed to analyze the expression of angiogenesis-associated genes. The AAV2-VEGF treatment significantly improved flap survival (p<0.05). Immunohistochemical staining showed increased VEGF expression in AAV2-VEGF treated flaps. The PCR array identified remarkable changes in 6 out of the 84 angiogenesis-associated genes in AAV2-VEGF treated flaps. Particularly, EGF, PDGF-A and VEGF-B genes were up-regulated in these flaps. In contrast, FGF2 gene expression was down-regulated. In conclusion, AAV2-VEGF improves flap survival and affects the expression of a series of endogenous growth factor genes, which likely play critical roles in the enhancement of ischemic flap survival.
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http://dx.doi.org/10.1111/j.1524-475X.2011.00705.x | DOI Listing |
Microsurgery
January 2025
Division of Plastic, Reconstructive and Aesthetic Surgery, University Hospital Bonn, University of Bonn, Bonn, Germany.
Open abdomen treatment (OAT) is associated with significant morbidity and mortality. In cases where primary or delayed fascial closure cannot be achieved, vacuum-assisted wound closure and mesh-mediated fascial traction are indicated, which often result in a planned ventral hernia. If secondary skin closure is not feasible, common treatment of granulated abdominal defects involves split-thickness skin-grafting or healing by secondary intention leading to significant scarring and sometimes mutilating defects.
View Article and Find Full Text PDFJ Reconstr Microsurg
December 2024
Emory University, Atlanta, United States.
Introduction Defects of the lower extremity often require free tissue transfer to provide adequate soft tissue reconstruction. Patients typically undergo a postoperative dangle protocol to condition the flap to withstand the increase in venous pressure. The purpose of this study was to evaluate the safety and postoperative length of stay after early initiation of dangle.
View Article and Find Full Text PDFCureus
December 2024
Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN.
An a (AEF) is a rare but life-threatening condition where an abnormal connection forms between the aorta and the gastrointestinal tract, most commonly the duodenum. It can be primary (arising spontaneously due to an aortic aneurysm or infection) or secondary (complicating prior vascular surgery). Immediate recognition and surgical intervention are critical to manage severe gastrointestinal bleeding and prevent fatal outcomes.
View Article and Find Full Text PDFHead Neck
December 2024
Department of Head & Neck Surgery, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
Objectives: To address controversies regarding target volume delineation for adjuvant intensity-modulated radiation therapy for oral cavity squamous cell carcinoma with pedicled flap reconstruction and elective nodal irradiation (ENI).
Materials And Methods: During target volume delineation, the primary tumor bed was the pre-surgical gross tumor volume with an additional isotropic margin of 5-10 mm. Additionally, the flap and body tissue junction were given a margin of 5-10 mm (if not already given).
Surg Radiol Anat
December 2024
Department of Hand-Foot Microsurgery, Shenzhen Nanshan People's Hospital, No. 89 Taoyuan Road, Nanshan District, Shenzhen, 518052, China.
Objective: This study explored the surgical technique and clinical application of the dorsal metacarpal cutaneous branch flap of the radial digital artery of the index finger.
Methods: Through the anatomical dissection of 10 hand specimens, we examined the origin and characteristics of the artery and its branches towards the hand dorsum. Furthermore, the soft tissue defects of the index finger in 12 patients admitted to our hospital between 2017 and 2021 were surgically repaired using the dorsal metacarpal cutaneous branch flap of the radial digital artery of the index finger.
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