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Research Article| Volume 46, ISSUE 1, P48-55, 1993

Neovascularisation precedes neural changes in the rat groin skin flap following denervation: an immunohistochemical study

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      Abstract

      We have employed immunohistochemical techniques to study neural and vascular changes in rat skin flaps. Following partial or total denervation, flaps were studied at 4, 7 or 12 days using antisera to PGP 9.5 (panneural marker), the neuropeptides CGRP (sensory nerves) and CPON (adrenergic nerve3) and an endothelial marker VWF. In partially denervated flaps, moderate increases in PGP-immunoreactive (PGP-IR) and CGRP-IR nerves and a mild increase in CPON-IR nerves in immediate surrounding skin preceded smaller increases in similar nerves around the pedicle. Following total denervation, mild increases in all nerve types at these locations were accompanied by a marked increase of these nerves in distant surrounding skin, 1–2 cm from the suture line. A gradual increase in endothelial cell staining (VWF) of blood vessels was seen in surrounding skin, flap beds and pedicles. Angiogenesis preceded flap reinnervation which occurred initially from surrounding skin, and later from the base, with sensory fibres appearing first.

      Reference

        • Adeymo O.
        • Wyburn G.M.
        Innervation of skin grafts.
        Transplantation Bulletin. 1957; 4: 152
        • Dalsgaard C.J.
        • Rydh M.
        • Haegerstrand A.
        Cutaneous innervation in man visualized with protein gene products 9.5 (PGP 9.5) antibodies.
        Histochemistry. 1989; 92: 385
        • Davis J.S.
        • Kitlowski E.A.
        Regeneration of nerves in skin grafts and skin flaps.
        American Journal of Surgery. 1934; 24: 501
        • Davis L.
        The return of sensation to transplanted skin.
        Surgery Gynecology and Obstetrics. 1934; 59: 533
        • Dennis-Donini S.
        Expression of dopaminergic phenotypes in the mouse olfactory bulb induced by the calcitonin gene-related peptide.
        Nature. 1989; 339: 701
        • Diamond J.
        • Jackson P.C.
        Regeneration and collateral sprouting of peripheral nerves.
        in: Jewett D.L. Relton McCarroll Jr., H. Nerve Repair and Regeneration, its clinical and experimental basis. 1st edition. C. V. Mosby Company, St. Louis1980: 115
        • Fitzgerald M.J.T.
        • Martin F.
        • Paletta X.F.
        Innervation of skin grafts.
        Surgery Gynecology and Obstetrics. 1967; 124: 808
        • Hall S.
        Regeneration in the peripheral nervous system.
        Neuropathology and Applied Neurobiology. 1989; 15: 513
        • Karanth S.S.
        • Dhital S.
        • Springall D.R.
        • Polak J.M.
        Reinnervation and neuropeptides in mouse skin flaps.
        Journal of the Autonomic Nervous System. 1990; 31: 127
        • Katoh N.
        • Ueda S.
        • Matsumoto Y.
        • Kishimoto S.
        • Yasuno H.
        • Kawata M.
        Target-specific innervation by autonomic and sensory nerve fibers in hairy fetal skin transplanted into the anterior eye chamber of adult rat.
        Cell and Tissue Research. 1991; 266: 259
        • Kjartansson J.
        • Dalsgaard C.J.
        Calcitonin gene-related peptide increases survival of musculocutaneous flap in the rat.
        European Journal of Pharmacology. 1987; 142: 355
        • Kjartansson J.
        • Lunberg T.
        • Samuelson U.E.
        • Dalsgaard C.J.
        • Heden P.
        Calcitonin gene-related peptide (CGRP) and transcutaneous electrical nerve stimulation (TENS) increase blood flow in a musculocutaneous flap in the rat.
        Acta Physiologica Scandinavica. 1988; 134: 89
        • Knight K.R.
        • Kawabata H.
        • Coe S.A.
        • Martin T.J.
        • Angus J.A.
        • O'Brien B.McC.
        The salvage of rabbit ischaemic epigastric free flaps using the vasodilator calcitonin gene related peptide.
        British Journal of Plastic Surgery. 1990; 43: 447
        • Mannerfelt L.
        Evaluation of functional sensation of skin grafts in the hand area.
        British Journal of Plastic Surgery. 1962; 15: 136
        • Nishikawa H.
        • Manek S.
        • Green C.J.
        The oblique rat groin flap.
        British Journal of Plastic Surgery. 1991; 44: 295
        • Nishikawa H.
        • Manek S.
        • Fryer P.R.
        • Green C.J.
        The warm ischaemic tolerance of rat adipomusculocutaneous flaps and ultrastructural change.
        Journal of Pathology. 1991; 163: 182A
        • O'Halloran D.J.
        • Bloom S.R.
        Calcitonin gene related peptide. A major neuropeptide and the most powerful vasodilator known.
        British Medical Journal. 1991; 302: 739
        • Phillips G.D.
        • Whitehead R.A.
        • Knighton D.R.
        Initiation and pattern of angiogenesis in wound healing in the rat.
        American Journal of Anatomy. 1991; 192: 257
        • Psillakis J.M.
        • Erhardt E.A.
        Reinnervation of skin grafts: an experimental study.
        Revista Brasileira de clinica e terapeutica. 1972; 1: 607
        • Terzis J.K.
        Functional aspects of reinnervation of free grafts.
        Plastic and Reconstructive Surgery. 1978; 58: 142
        • Varon S.
        • Williams L.R.
        Peripheral nerve regeneration in a silicone model chamber: cellular and molecular aspects.
        Peripheral Nerve Repair and Regeneration. 1986; 1: 9
        • Vracko R.
        • Thorning D.
        • Frederickson R.G.
        Fate of nerve fibres in necrotic, healing, and healed rat myocardium.
        Laboratory Investigation. 1990; 63: 490
        • Waris T.
        Reinnervation of free skin autografts in the rat.
        Scandinavian Journal of Plastic and Reconstructive Surgery. 1978; 12: 85
        • Waris T.
        Innervation of the skin, skin transplants, flaps and scars. An experimental, histochemical study in the rat.
        Acta Chirurgica Scandinavica. 1978;
        • Woodward K.L.
        • Kenshalo D.R.
        The recovery of sensory function following skin flaps in humans.
        Plastic and Reconstructive Surgery. 1987; 79: 428