title: Effect of photodynamic therapy on revascularization of fasciocutaneous flaps.
abstract: OBJECTIVE
  Photodynamic therapy (PDT) may be used as an adjuvant intraoperative treatment to improve locoregional control. PDT has been shown both to delay wound healing and to have a deleterious effect on flap survival after a primary ischemic insult. This delay in wound healing may make the flap dependent on its pedicled blood supply for a prolonged period. Long-term flap loss may be experienced. The effect of PDT on flap revascularization, with subsequent dependence on its vascular pedicle, is evaluated.
  
  
  METHODS
  Randomized controlled trial using a rodent model.
  
  
  METHODS
  A rat fasciocutaneous flap was used. Study groups were as follows: group I received no treatment; group II received treatment with 630-nm light; groups IH and IV were given Photofrin (in group III, loupes without a fiberoptic light source were used for flap elevation, and in group IV, light source was employed); and group V was given Photofrin and 630-nm light. Primary ischemic times of 2 or 4 hours were used. Vascular pedicles were ligated on postoperative day (POD) 5, 6, or 7, and percentage of flap survival was evaluated 7 days later.
  
  
  RESULTS
  With 2 hours of ischemia, revascularization was decreased in the PDT group on POD 6 (P < .05) and on day 7 (P < .005) when compared with the other groups. With 4 hours of ischemia, revascularization was decreased in the PDT group on PODs 5 (P < .001), 6 (P < .01), and 7 (P < .005).
  
  
  CONCLUSIONS
  Intraoperative PDT decreases revascularization of a rat fasciocutaneous flap.
authors.affiliation: Department of Otolaryngology--Head and Neck Surgery, University of Pennsylvania, Philadelphia 19104-4283, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Belmont
authors.forename: N
authors.initials: N
authors.lastname: Marabelle
authors.forename: T S
authors.initials: TS
authors.lastname: Mang
authors.forename: R
authors.initials: R
authors.lastname: Hall
authors.forename: M K
authors.initials: MK
authors.lastname: Wax
mesh_terms: D000818:Animals; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D062109:Dermatologic Surgical Procedures; D004195:Disease Models, Animal; D000071938:Fasciotomy; D006085:Graft Survival / Q000502:physiology; D006258:Head and Neck Neoplasms / Q000601:surgery; D007511:Ischemia / Q000628:therapy*; D008297:Male; D018919:Neovascularization, Physiologic / Q000502:physiology; D010778:Photochemotherapy / Q000379:methods*; D011183:Postoperative Complications; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D013524:Surgical Flaps / Q000098:blood supply*; D014945:Wound Healing