Antonini Andrea, Zacchigna Serena, Papa Giovanni, Novati Federico, Pascone Michele, Giacca Mauro
Plastic Surgery Unit, Faculty of Medicine and Surgery, University of Trieste, Italy.
Microsurgery. 2007;27(5):439-45. doi: 10.1002/micr.20378.
When harvesting microsurgical flaps, the main goals are to obtain as much tissue as possible based on a single vascular pedicle and a reliable vascularization of the entire flap. These aims being in contrast to each other, microsurgeons have been looking for an effective way to enhance skin and muscle perfusion in order to avoid partial flap loss in reconstructive surgery. In this study we demonstrate the efficacy of VEGF 165 delivered by an Adeno-Associated Virus (AAV) vector in two widely recognized rat flap models. In the rectus abdominis myocutaneous flap, intramuscular injection of AAV-VEGF reduced flap necrosis by 50%, while cutaneous delivery of the same amount of vector put down the epigastric flap's ischemia by >40%. Histological evidence of neoangiogenesis (enhanced presence of CD31-positive capillaries and alpha-Smooth Muscle Actin-positive arteriolae) confirmed the therapeutic effect of AAV-VEGF on flap perfusion.
在切取显微外科皮瓣时，主要目标是基于单一血管蒂获取尽可能多的组织，并确保整个皮瓣有可靠的血管化。由于这些目标相互矛盾，显微外科医生一直在寻找一种有效的方法来增强皮肤和肌肉灌注，以避免重建手术中皮瓣部分坏死。在本研究中，我们在两种广泛认可的大鼠皮瓣模型中证明了腺相关病毒（AAV）载体递送的VEGF 165的有效性。在腹直肌肌皮瓣中，肌肉内注射AAV-VEGF可使皮瓣坏死减少50%，而相同剂量载体的皮肤递送可使腹壁皮瓣的缺血减少>40%。新生血管形成的组织学证据（CD31阳性毛细血管和α-平滑肌肌动蛋白阳性小动脉的存在增加）证实了AAV-VEGF对皮瓣灌注的治疗效果。
