Meirer R, Huemer G M, Oehlbauer M, Wanner S, Piza-Katzer H, Kamelger F S
Department of Plastic and Reconstructive Surgery, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
J Plast Reconstr Aesthet Surg. 2007;60(3):266-71. doi: 10.1016/j.bjps.2005.12.050. Epub 2006 Jun 12.
The effect of gene therapy with adenovirus-mediated (Ad) vascular endothelial growth factor (VEGF) was compared to that of shock wave (SW) therapy on skin flap survival in a rat model, using the epigastric skin flap, based solely on the right inferior epigastric vessels. Thirty male Sprague-Dawley rats were randomly divided into three groups (SW-group, Ad-VEGF-group, and Control-group) of 10 rats each. Immediately after surgery, the SW-group was administered 2500 impulses at 0.15mJ/mm(2), in the Ad-VEGF-group injections were made to the subdermal space whereas the Control-group received no treatment. Flap viability was evaluated on day 7 after the operation. Standardised digital pictures of the flaps were taken and transferred to the computer, and necrotic zones relative to total flap surface area were measured and expressed as percentages. Overall, significantly smaller areas of necrotic zones were noted in the SW-group and the Ad-VEGF-group compared with the Control-group (SW-group: median 2.23% (range: 0-5.1) versus Control-group: median 17.4% (range: 11.8-22.8) (p<0.05); Ad-VEGF-group: median 9.25% (range: 7.6-11.9) versus Control-group: median 17.4% (range: 11.8-22.8) (p<0.05)). Furthermore, in the SW-group, areas of necrotic zones were significantly smaller than in Ad-VEGF-group (SW-group: median 2.23% (range: 0-5.1) versus Ad-VEGF-group: median 9.25% (range: 7.6-11.9) (p<0.05)). We conclude that treatment with SW enhances epigastric skin flap survival significantly more than Ad-VEGF treatment and also represents a feasible and cost effective technique to improve blood supply in ischaemic tissue.
在大鼠模型中，使用仅基于右下腹壁血管的腹壁皮瓣，将腺病毒介导（Ad）的血管内皮生长因子（VEGF）基因治疗与冲击波（SW）治疗对皮瓣存活的影响进行比较。30只雄性Sprague-Dawley大鼠被随机分为三组（SW组、Ad-VEGF组和对照组），每组10只大鼠。术后立即对SW组给予2500次脉冲，能量为0.15mJ/mm(2)，Ad-VEGF组在皮下间隙进行注射，而对照组不进行治疗。在术后第7天评估皮瓣活力。拍摄皮瓣的标准化数码照片并传输到计算机，测量相对于皮瓣总面积的坏死区域，并以百分比表示。总体而言，与对照组相比，SW组和Ad-VEGF组的坏死区域明显更小（SW组：中位数2.23%（范围：0-5.1），对照组：中位数17.4%（范围：11.8-22.8）（p<0.05）；Ad-VEGF组：中位数9.25%（范围：7.6-11.9），对照组：中位数17.4%（范围：11.8-22.8）（p<0.05））。此外，SW组的坏死区域明显小于Ad-VEGF组（SW组：中位数2.23%（范围：0-5.1），Ad-VEGF组：中位数9.25%（范围：7.6-11.9）（p<0.05））。我们得出结论，与Ad-VEGF治疗相比，SW治疗能显著提高腹壁皮瓣的存活率，并且也是一种改善缺血组织血液供应的可行且具有成本效益的技术。
