Zhang F, Oswald T, Lin S, Cai Z, Lei M, Jones M, Angel M F, Lineaweaver W C
Division of Plastic Surgery, The University of Mississippi Medical Center, Jackson, MS 39216, USA.
Br J Plast Surg. 2003 Oct;56(7):653-9. doi: 10.1016/s0007-1226(03)00214-5.
The induction of endogenous vascular endothelial growth factor (VEGF) production in the skin flap with ischemic injury and the effect of exogenous VEGF on survival of the ischemic skin flap were studied in rats. A dorsal flap model (3x10 cm(2)) was used in this study. In Part I, biopsies were taken from the flap at 2.5, 5.5, and 8.5 cm distances from the distal edge at 0, 6, 12, and 24 h after the flaps were sutured. Malonyldialdehyde (MDA) and VEGF(165) protein level were measured. In Part II, exogenous VEGF (1 microg/ml) was injected subdermally into the flaps in 14 rats before the flaps were replaced. Flaps that received a saline injection were used as the controls. The skin paddle survival was measured on postoperative day five. The results showed that the MDA level in the distal part of the flap significantly increased at 24 h postoperatively when compared to MDA in other parts of the flap. However, VEGF levels in the distal part of the flap significantly decreased when compared to the middle part of the flap. Subdermal injection of exogenous VEGF to the distal area of the flap could significantly improve survival of the distal flap (89% of total skin paddle) when compared to the control, which had a 64% mean percent survival. We conclude that production of endogenous VEGF protein is significantly increased in the skin flap with mild ischemia, but decreased in the flap with severe ischemia. Administration of exogenous VEGF could significantly enhance survival of ischemic flaps.
研究了大鼠缺血性损伤皮瓣内源性血管内皮生长因子（VEGF）的产生以及外源性VEGF对缺血皮瓣存活的影响。本研究采用背部皮瓣模型（3×10 cm²）。在第一部分，皮瓣缝合后0、6、12和24小时，在距皮瓣远端边缘2.5、5.5和8.5 cm处取皮瓣组织活检。检测丙二醛（MDA）和VEGF（165）蛋白水平。在第二部分，14只大鼠在皮瓣复位前皮下注射外源性VEGF（1 μg/ml）。注射生理盐水的皮瓣作为对照。术后第5天测量皮瓣存活情况。结果显示，与皮瓣其他部位的MDA相比，术后24小时皮瓣远端部分的MDA水平显著升高。然而，与皮瓣中部相比，皮瓣远端部分的VEGF水平显著降低。与平均存活率为64%的对照组相比，向皮瓣远端区域皮下注射外源性VEGF可显著提高远端皮瓣的存活率（占整个皮瓣的89%）。我们得出结论，轻度缺血皮瓣内源性VEGF蛋白产生显著增加，但重度缺血皮瓣内源性VEGF蛋白产生减少。给予外源性VEGF可显著提高缺血皮瓣的存活率。
