title: Obesity alters rat abdominal flap survival.
abstract: Obesity presents a risk factor for flap-related complications in autologous tissue breast reconstruction. In this study, an animal model was developed to examine this phenomenon. Abdominal flaps based on a superficial inferior epigastric pedicle were elevated in an experimental group of obese Zucker (fa/fa) rats (n = 8; mean weight, 413 g) and in their lean littermates (n = 9; mean weight, 276 g). Flap tissue was harvested from a subset of both groups for baseline characterization, including histology, and assays for ATP and oxidative phosphorylation uncoupler, UCP-2. Flaps were then evaluated for survival by planimetry at 4 and 7 days postprocedure. Flap survival 7 days postoperatively was reduced in obese (42.0% +/- 8.6%) versus lean (70.3% +/- 6.7%) rats (P < 0.05). At baseline, flap tissue of obese animals had decreased ATP content relative to lean counterparts (0.12 +/- 0.12 nM/microg vs 0.36 +/- 0.23 nM/microg protein, P < 0.05), whereas UCP2 mRNA was higher in obese flap tissue versus lean. Reduced viability of obese flaps may be attributable to decreased baseline energy stores due to oxidative phosphorylation uncoupling by UCP-2. This study is the first to introduce a promising animal model for examining the effect of obesity on increased flap-related complications in breast reconstruction using autologous tissue.
authors.affiliation: Department of Surgery, Medical University of South Carolina, Charleston 29425, USA.
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Reyna
authors.forename: Mark E
authors.initials: ME
authors.lastname: Feldmann
authors.forename: Zachary P
authors.initials: ZP
authors.lastname: Evans
authors.forename: O
authors.initials: O
authors.lastname: Seung-Jun
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Chavin
mesh_terms: D000005:Abdomen; D000255:Adenosine Triphosphate / Q000378:metabolism; D000818:Animals; D001835:Body Weight; D004195:Disease Models, Animal; D007473:Ion Channels; D008297:Male; D016462:Mammaplasty / Q000379:methods*; D026901:Membrane Transport Proteins / Q000378:metabolism; D024101:Mitochondrial Proteins / Q000378:metabolism; D009765:Obesity / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D012333:RNA, Messenger / Q000378:metabolism; D051381:Rats; D011924:Rats, Zucker; D050151:Subcutaneous Fat / Q000033:anatomy & histology; D013524:Surgical Flaps / Q000502:physiology*; D000071246:Uncoupling Protein 2
chemical_list: D007473:Ion Channels; D026901:Membrane Transport Proteins; D024101:Mitochondrial Proteins; D012333:RNA, Messenger; C000604391:Ucp2 protein, rat; D000071246:Uncoupling Protein 2; D000255:Adenosine Triphosphate