Vascular Endothelium Growth Factor, Surgical Delay, and Skin Flap Survival

Lineaweaver, William C.; Lei, Man-Ping; Mustain, W. Conan; Oswald, Tanya; Cui, Dongmei; Zhang, Feng

doi:10.1097/01.sla.0000128682.53915.92

Cited by 103 publications

(55 citation statements)

References 50 publications

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“…24 Lineaweaver et al showed that vascular endothelium growth factor could be an important element in the delay phenomenon. 26 Vascular endothelium growth factor affects microcirculation acutely by change in vascular permeability and in a sustained manner by promoting angiogenesis. 26 In our study, the muscle flap can survive after the delay based on the intrinsic vascularity of the nerve.…”

Section: Discussionmentioning

confidence: 99%

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A pedicled muscle flap based solely on a neural pedicle

et al. 2009

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We tested the hypothesis that the intrinsic vascular plexus of the motor nerve could support viability in a rat hindlimb muscle flap. In a preliminary study, we examined the course and vascularity of the sciatic nerve, the peroneal nerve, and the peroneous longus muscle in the rat hindlimb via anatomic dissection, microangiography, and histologic study (n = 10 animals). On the basis of this examination, the peroneous longus muscle was chosen as our experimental model in this study. In 12 animals, the peroneus longus was acutely elevated, which severed all tendinous and vascular structures, this left the muscle pedicled on the motor nerve only (Group I). Animals in Group II underwent a staged elevation of the flap with division of the vascular pedicle, the tendon of insertion, and the tendon of origin during separate procedures that were 5 days apart (n = 12). Muscle viability was evaluated by gross inspection, measurement of muscle weight and length, nitroblue tetrazlium (NBT) staining, microangiography, and histology. NBT staining demonstrated that immediate elevation of the peroneus longus muscle flaps led to an average necrotic area of 80.6% +/- 9.8% (Group I). A significant improvement in viability was observed for muscle flaps of animals in Group II, with peroneus longus muscle necrosis averaging 25.6% +/- 9.3%. Microangiography demonstrated that the intrinsic vascularity of nerve was increased dramatically in Group II. These data support the hypothesis that the intrinsic vascular plexus of the motor nerve of a skeletal muscle can support at least partial viability of a muscle flap. However, this vascular axis is inadequate to support complete viability of a muscle flap if the flap is elevated immediately. If a staged elevation affects a surgical delay, the viability of a muscle flap elevated on a neural pedicle can be increased significantly. With adjustments in the delay procedure, this strategy may allow transfer of muscle flaps when maintenance or reconstitution of the primary vascular axis is not possible.

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Section: Discussionmentioning

confidence: 99%

“…26 Vascular endothelium growth factor affects microcirculation acutely by change in vascular permeability and in a sustained manner by promoting angiogenesis. 26 In our study, the muscle flap can survive after the delay based on the intrinsic vascularity of the nerve. Following the delay procedure, muscle atrophy was determined.…”

Section: Discussionmentioning

confidence: 99%

A pedicled muscle flap based solely on a neural pedicle

et al. 2009

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“…In these strategies, one of the recent trends is local delivery of angiogenic growth factors, such as basic fibroblast growth factor (bFGF) or vascular endothelial growth factor (VEGF) [3][4][5][6]. These growth factors promote specific angiogenic reactions to and in the targeted ischemic tissue and enhance its local circulation by various mechanisms.…”

Section: Introductionmentioning

confidence: 99%

Controlled Delivery of bFGF Remodeled Vascular Network in Muscle Flap and Increased Perfusion Capacity Via Minor Pedicle

Yasuda

Koyama

Tabata

et al. 2008

Journal of Surgical Research

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“…11,12 Improved wound healing with the application of exogenous VEGF has been shown in multiple myocutaneous flap models. [13][14][15][16][17] To date, VEGF gene therapy has not been employed within the gastrointestinal (GI) tract to promote anastomotic healing.…”

Section: Introductionmentioning

confidence: 99%