Effects of transpositional muscle flaps transfected with vascular endothelial growth factor gene in the treatment of experimental osteomyelitis.
BACKGROUND
Based on the angiogenetic and stimulating effects of bone healing and formation of vascular endothelial growth factor (VEGF), the present study was designed to assess the efficacy of VEGF gene application in the management of experimentally induced osteomyelitis.


METHODS
Thirty-two male Sprague Dawley rats were divided into 4 groups, and osteomyelitis was induced in the left tibial bones. Group 1 (n=8) was designated as a control group, and, after the induction of osteomyelitis, no treatment was applied for a period of 4 weeks. Group 2 (n=8) received only antibiotic treatment for 4 weeks following induction of osteomyelitis. In Group 3 (n=8), proximally pedicled gastrocnemius muscle flap was transposed over the osteomyelitic region following induction of osteomyelitis and antibiotic treatment applied for a 4-week period. In Group 4 (n=8), VEGF gene-transfected gastrocnemius muscle flap was transposed over the osteomyelitic region following identical antibiotic regimen applied for a 4-week period. For each group, body temperature, white blood cell (WBC) count, and radiological and histological parameters were evaluated.


RESULTS
Body temperature and WBC count remained high in the control group, but returned to normal in Groups 2, 3, and 4 after the third week of treatment. Statistical analysis of the total scores of radiological and histological results revealed significant differences between Groups 1 and 3, Groups 1 and 4, Groups 2 and 3, and Groups 2 and 4 (p<0.05). Regarding radiological parameters of abscess and sequester, and histological parameter of abscess, statistically significant differences were found between Group 4 and the other groups (p<0.05).


CONCLUSIONS
The efficacy of the VEGF gene-transfected muscle flap in the management of experimental osteomyelitis was proven by the results of the present study.
Department of Plastic and Reconstructive Surgery, Military Hospital, Baku-Azerbaijan.
Mahir
M
Aliyev
Department of Plastic and Reconstructive Surgery, Gülhane Military Medical Academy, Ankara-Turkey. andac_aykan@gata.edu.tr.
Andaç
A
Aykan
Department of Plastic and Reconstructive Surgery, Gülhane Military Medical Academy, Ankara-Turkey.
Muhitdin
M
Eski
Department of Nuclear Medicine, Gülhane Military Medical Academy, Ankara-Turkey.
Nuri
N
Arslan
Department of Pathology, Gülhane Military Medical Academy, Ankara-Turkey.
Bülent
B
Kurt
Department of Plastic and Reconstructive Surgery, Gülhane Military Medical Academy, Ankara-Turkey.
Mustafa
M
Şengezer
D000818:Animals; D015870:Gene Expression; D015316:Genetic Therapy; D008297:Male; D023421:Models, Animal; D018482:Muscle, Skeletal / Q000098:blood supply / Q000378:metabolism / Q000637:transplantation*; D010019:Osteomyelitis / Q000601:surgery*; D051381:Rats; D017207:Rats, Sprague-Dawley; D013524:Surgical Flaps; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics / Q000378:metabolism*
D042461:Vascular Endothelial Growth Factor A