title: Novel skin chamber for rat ischemic flap studies in regenerative wound repair.
abstract: BACKGROUND
  In plastic surgery, skin flap is an important approach to reconstructive wound repairs. The rat dorsal skin flap is a clinically relevant and popular animal model to investigate and evaluate flap survival and necrosis. Nonetheless, flap survival is often unstable with unpredictable outcomes, regardless of previous attempts at design modification.
  
  
  RESULTS
  In the present study, we report a novel flap chamber that provides stable and reproducible outcomes by separating the dorsal skin flap from its surrounding skin by in situ immobilization. The flap chamber blocks circulation that disturbs flap ischemia from both basal and lateral sides of the flap tissue. Demarcation of skin necrosis is macroscopically evident on the flap and supported by distinct changes in histological architecture under microscopic examination. The utility of the novel skin flap chamber is further proven by applying it to the examination of flap survival in streptozotocin-induced diabetic rats with an increase in skin necrosis. The flap chamber also affords size modifications where a narrower flap chamber increases ischemia and provides manipulable therapeutic windows for studying cell therapies. Accordingly, intradermal injection of endothelial cells 3 days before flap ischemia significantly increases the survival of skin flaps.
  
  
  CONCLUSIONS
  The novel flap chamber not only may stabilize the skin flap and provide reproducible outcomes that overcome the shortfalls of the traditional ischemic flap but also may afford size modifications that support research designs and test therapeutic approaches to regenerative repair.
authors.affiliation: Division of Plastic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|International Research Center for Wound Repair and Regeneration, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Yuan-Yu
authors.initials: YY
authors.lastname: Hsueh
authors.affiliation: Division of Plastic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|International Research Center for Wound Repair and Regeneration, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Duo-Hsiang
authors.initials: DH
authors.lastname: Wang
authors.affiliation: Department of Cell Biology & Anatomy, National Cheng Kung University, Tainan, Taiwan.|Institute of Basic Medical Sciences, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Tzu-Chieh
authors.initials: TC
authors.lastname: Huang
authors.affiliation: Department of Cell Biology & Anatomy, National Cheng Kung University, Tainan, Taiwan.|Institute of Basic Medical Sciences, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Ya-Ju
authors.initials: YJ
authors.lastname: Chang
authors.affiliation: Department of Occupational Therapy, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Wei-Chi
authors.initials: WC
authors.lastname: Shao
authors.affiliation: International Research Center for Wound Repair and Regeneration, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|The Saban Research Institute of Children's Hospital Los Angeles and Department of Surgery, Keck school of Medicine, University of Southern California, Los Angelas, CA, USA.
authors.forename: Tai-Lan
authors.initials: TL
authors.lastname: Tuan
authors.affiliation: Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|International Research Center for Wound Repair and Regeneration, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Hughes
authors.affiliation: Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. joshccwu@mail.ncku.edu.tw.|International Research Center for Wound Repair and Regeneration, College of Medicine, National Cheng Kung University, Tainan, Taiwan. joshccwu@mail.ncku.edu.tw.|Department of Cell Biology & Anatomy, National Cheng Kung University, Tainan, Taiwan. joshccwu@mail.ncku.edu.tw.|Institute of Basic Medical Sciences, National Cheng Kung University, Tainan, Taiwan. joshccwu@mail.ncku.edu.tw.|Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan. joshccwu@mail.ncku.edu.tw.|Medical Device Innovation Center, National Cheng Kung University, No. 1, University Rd., Tainan, Taiwan. joshccwu@mail.ncku.edu.tw.
authors.forename: Chia-Ching
authors.initials: CC
authors.lastname: Wu
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D062109:Dermatologic Surgical Procedures / Q000379:methods*; D003921:Diabetes Mellitus, Experimental / Q000139:chemically induced / Q000150:complications / Q000473:pathology / Q000601:surgery*; D004195:Disease Models, Animal; D006085:Graft Survival; D061307:Human Umbilical Vein Endothelial Cells / Q000166:cytology / Q000637:transplantation; D006801:Humans; D007271:Injections, Intradermal; D008297:Male; D009336:Necrosis / Q000276:immunology / Q000517:prevention & control*; D051381:Rats; D017207:Rats, Sprague-Dawley; D044968:Regenerative Medicine / Q000379:methods; D015203:Reproducibility of Results; D012867:Skin / Q000276:immunology / Q000378:metabolism; D013311:Streptozocin; D013524:Surgical Flaps / Q000637:transplantation*; D000072836:Surgical Wound / Q000150:complications / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D014945:Wound Healing
chemical_list: D001786:Blood Glucose; D013311:Streptozocin
keywords: Cell therapy; Diabetes; McFarlane flap; Skin flap; Skin flap chamber