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Improvement of the Inferior Epigastric Artery Flap Viability Using Adenovirus-mediated VEGF and COMP-angiopoietin-1  

Yoo, Eun Kyung (Department of Plastic and Reconstructive Surgery Keimyung University School of Medicine)
Son, Daegu (Department of Plastic and Reconstructive Surgery Keimyung University School of Medicine)
Kim, Hyung Tae (Department of General Surgery Keimyung University School of Medicine)
Lee, In Kyu (Department of Internal Medicine, Kyungpook National University School of Medicine)
Choi, Taehyun (Department of Plastic and Reconstructive Surgery Keimyung University School of Medicine)
Kim, Junhyung (Department of Plastic and Reconstructive Surgery Keimyung University School of Medicine)
Han, Kihwan (Department of Plastic and Reconstructive Surgery Keimyung University School of Medicine)
Publication Information
Archives of Plastic Surgery / v.36, no.1, 2009 , pp. 1-10 More about this Journal
Abstract
Purpose: Partial necrosis of skin flaps remains a substantial problem in reconstructive surgery. We investigated the potential use of an adenovirus vector encoding the VEGF, COMP-angiopoietin-1 gene in an attempt to promote the viability of the inferior epigastric artery flap in a rat model. Methods: Three by six cm lower abdominal transverse skin flaps, supplied only by the left inferior epigastric artery, were designed. After skin flap elevation, the adenovirus VEGF and adenovirus COMP-angiopoietin-1 were injected into the distal portion of the flap, which has a high tendency of developing flap ischemia. Control animals were injected with the same volume of normal saline. On 3, 7 and 14 days after the flap elevation, the flap survival and vascularization were assessed using Visitrak digital$^{(R)}$, CD31 immunohistochemistry in addition to evaluating the general histological characteristics. Results: There was a significant increase in the mean percentage of flap viability by 89.8%, 91.1% and 94.8% in flaps transfected with adenovirus VEGF, COMP-angiopoietin-1, coadministraion of VEGF and COMP-angiopoietin-1 at seven days, and by 95.6%, 94.8% and 96.3% at 14 days. Histological assessment revealed that there were more blood vessels formed after adenovirus with VEGF, COMP-angiopoietin-1 or VEGF plus COMP-angiopoietin-1 than with adenovirus Lac Z. Conclusion: The results of this study suggest that adenovirus-mediated VEGF, COMP-angiopoietin-1 gene therapy, promote therapeutic angiogenesis in patients that undergo reconstructive procedures.
Keywords
VEGF; Angiopoietin; Gene therapy; Flap;
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