Improved skin flap survival in venous ischemia-reperfusion injury with the use of adipose-derived stem cells.
BACKGROUND
The purpose of this study was to investigate the efficacy of stem cell therapy as an adjuvant treatment for congested skin flap.


METHODS
Sprague-Dawley rats (n = 21) were randomized into three groups. In group I, the flap was sutured without venous ischemia. In group II, the vein was selectively clamped for 4 hours, and complete medium was administered upon clamp removal. In group III, ADSCs were administered upon removing the clamp. On postoperative day 7, the survival areas and the histopathologic findings were assessed. In addition, the expression of heme oxygenase (HO)-1 and nuclear factor (NF)-κB was assessed using immunofluorescent staining and western blot analyses.


RESULTS
Compared with group II, group III showed significantly increased flap survival (31.2% ± 11.9% vs. 51.6% ± 13.6%, P < 0.05). The degree of histological abnormalities was significantly lower in group III than in group II (9.38% ± 1.39 vs. 6.46% ± 2.57, P < 0.05). In addition, in group III, the expression of NF-κB was significantly lower (0.51 ± 0.21 vs. 0.34 ± 0.21, P < 0.05), whereas that of HO-1 was significantly higher (0.25 ± 0.11 vs. 0.43 ± 0.18, P < 0.01). Immunofluorescent staining also showed more HO-1-positive cells in group III than in group II (10.9% ± 1.6% vs. 16.0% ± 1.7%, P < 0.01).


CONCLUSIONS
Our study demonstrated that treatment with ADSCs significantly increased flap survival in venous ischemia-reperfusion conditions. Further investigation of these protective effects and optimization of the treatment protocol could make cell therapy a viable treatment.
Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, 137-701, Republic of Korea.
Hyun Ho
HH
Han
Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, 137-701, Republic of Korea.
Young Min
YM
Lim
Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, 137-701, Republic of Korea.
Sang Wook
SW
Park
Department of Molecular Biomedicine, College of Medicine, The Catholic University of Korea, Seoul, 137-701, Republic of Korea.
Su Jin
SJ
Lee
Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, 137-701, Republic of Korea.
Jong Won
JW
Rhie
Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, 137-701, Republic of Korea.
Jung Ho
JH
Lee
D000818:Animals; D015153:Blotting, Western; D058752:Free Tissue Flaps / Q000098:blood supply* / Q000637:transplantation; D006085:Graft Survival; D008297:Male; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D019651:Plastic Surgery Procedures; D015427:Reperfusion Injury / Q000628:therapy*; D012867:Skin / Q000098:blood supply*; D016038:Skin Transplantation; D033581:Stem Cell Transplantation / Q000379:methods*; D050151:Subcutaneous Fat / Q000166:cytology