Summary
The effect of gene therapy with adenovirus-mediated (Ad) vascular endothelial growth
factor (VEGF) was compared to that of shock wave (SW) therapy on skin flap survival
in a rat model, using the epigastric skin flap, based solely on the right inferior
epigastric vessels.
Thirty male Sprague–Dawley rats were randomly divided into three groups (SW-group,
Ad-VEGF-group, and Control-group) of 10 rats each. Immediately after surgery, the
SW-group was administered 2500 impulses at 0.15 mJ/mm2, in the Ad-VEGF-group injections were made to the subdermal space whereas the Control-group
received no treatment. Flap viability was evaluated on day 7 after the operation.
Standardised digital pictures of the flaps were taken and transferred to the computer,
and necrotic zones relative to total flap surface area were measured and expressed
as percentages.
Overall, significantly smaller areas of necrotic zones were noted in the SW-group
and the Ad-VEGF-group compared with the Control-group (SW-group: median 2.23% (range:
0–5.1) versus Control-group: median 17.4% (range: 11.8–22.8) (p<0.05); Ad-VEGF-group: median 9.25% (range: 7.6–11.9) versus Control-group: median
17.4% (range: 11.8–22.8) (p<0.05)). Furthermore, in the SW-group, areas of necrotic zones were significantly smaller
than in Ad-VEGF-group (SW-group: median 2.23% (range: 0–5.1) versus Ad-VEGF-group:
median 9.25% (range: 7.6–11.9) (p<0.05)).
We conclude that treatment with SW enhances epigastric skin flap survival significantly
more than Ad-VEGF treatment and also represents a feasible and cost effective technique
to improve blood supply in ischaemic tissue.
Keywords
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Article info
Publication history
Published online: June 15, 2006
Accepted:
December 6,
2005
Received:
February 23,
2005
Identification
Copyright
© 2006 The British Association of Plastic Surgeons. Published by Elsevier Inc. All rights reserved.
