Improving flap survival by transplantation of a VEGF-secreting endothelised scaffold during distal pedicle flap creation.
The benefits of a VEGF-secreting endothelised scaffold on the survival of distal flaps with early pedicle flap division were evaluated in a rabbit model. We bioengineered a scaffold based on a fibrin matrix in which endothelial cells, genetically modified with a VEGF-encoding adenoviral vector were embedded. We distributed subjects in four groups.


METHODS
Eight rabbits conditioned with endothelial cells embedded in a fibrin scaffold. The pedicle was divided after a period of 5 days; and eight rabbits conditioned with endothelial cells embedded in a fibrin scaffold but in this group the pedicle was divided after a period of 2 days.


METHODS
Eight rabbits conditioned with VEGF-secreting endothelial cells embedded in a fibrin scaffold; the pedicle was divided after a period of 5 days. And eight rabbits conditioned with VEGF-secreting endothelial cells but the pedicle was divided after a period of 2 days. The percentages of survival were 95.62+/-4.95% for the VEGF-producing scaffold vs. 51.25+/-45.88% for a non-VEGF secreting scaffold when sectioning the pedicle after 5 days. The percentage of survival of flaps in the group grafted with the VEGF-secreting scaffold was 55.62% compared to 2.5% in the group receiving the non-VEGF scaffold when the pedicle was sectioned after 2 days. The CD 31 immunostaining studies showed a dramatic increase in angiogenesis in the flaps conditioned by the VEGF-producing scaffolds. These data revealed that endothelised VEGF-secreting scaffold during flap creation could be a suitable approach in reconstructive surgery.
Lasso
J M
JM
Servicio de Cirugía Plástica y Reparadora, Hospital General Universitario Gregorio Marañón, Madrid, Spain. jm_lasso@hotmail.com <jm_lasso@hotmail.com>
Del Río
M
M
García
M
M
Martínez Calleja
V
V
Nava
P
P
Muñoz-Fernández
M A
MA
Pérez Cano
R
R
D000818:Animals; D042783:Endothelial Cells / Q000378:metabolism; D004730:Endothelium, Vascular / Q000166:cytology / Q000378:metabolism; D005337:Fibrin; D015316:Genetic Therapy / Q000379:methods*; D005822:Genetic Vectors; D006085:Graft Survival; D008297:Male; D018919:Neovascularization, Physiologic; D010446:Peptide Fragments / Q000235:genetics / Q000378:metabolism*; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000378:metabolism; D011817:Rabbits; D019651:Plastic Surgery Procedures / Q000379:methods; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D023822:Tissue Engineering / Q000379:methods*; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics / Q000378:metabolism*
D010446:Peptide Fragments; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D042461:Vascular Endothelial Growth Factor A; C511613:vascular endothelial growth factor A (138-165); D005337:Fibrin