The Affiliated Hospital of Stomatology, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Aesthetic Plast Surg. 2013 Oct;37(5):1023-33. doi: 10.1007/s00266-013-0200-7. Epub 2013 Aug 16.
No effective treatments have been found for flap necrosis. Animal models that focus on the initial flap viability are inappropriate for necrotic wound studies. Keratinocyte growth factor (KGF) promotes keratinocyte proliferation with stronger activity and fewer complications and thus may be useful for necrotic flap wound healing.
Rats with modified flap necrosis were randomly divided into four groups. An adenoviral vector expressing KGF was injected subdermally in the back of the animals after necrosis began. The expression and effect of KGF was assessed by real-time polymerase chain reaction, enzyme-linked immunoassay, and transwell, and wound healing was monitored.
The plasmid and adenovirus were able to express KGF and stimulate epithelial cell growth (p = 0.029). Histology showed that the necrosis healed fastest in the KGF administration group than in the control groups (p < 0.01). The adenovirus-mediated KGF (Ad-KGF) group had the thickest epithelium on days 15 (p = 0.044) and 25 (p = 0.014). The KGF level in the blood serum soared 10 and 15 days postoperatively (p < 0.01) but returned to baseline by day 25 (p = 0.561). The KGF mRNA levels in vivo increased dramatically in the Ad-KGF group (p = 0.037).
The extended flap model is applicable in necrotic wound study. Keratinocyte growth factor can promote secondary necrotic flap wound healing, and administration of KGF can be achieved by an adenoviral vector.
目前尚无有效的治疗方法可用于皮瓣坏死。关注皮瓣初始存活的动物模型并不适合用于研究坏死性伤口。角质细胞生长因子（KGF）可促进角质细胞增殖，且活性更强，并发症更少，因此对于坏死皮瓣伤口愈合可能有用。
对改良皮瓣坏死的大鼠进行随机分组，在坏死开始后，在动物背部皮下注射表达 KGF 的腺病毒载体。通过实时聚合酶链反应、酶联免疫吸附试验和 Transwell 评估 KGF 的表达和作用，并监测伤口愈合情况。
质粒和腺病毒均能表达 KGF 并刺激上皮细胞生长（p = 0.029）。组织学检查表明，KGF 给药组的坏死愈合最快（p < 0.01）。在第 15 天（p = 0.044）和第 25 天（p = 0.014），腺病毒介导的 KGF（Ad-KGF）组的上皮最厚。术后第 10 天和第 15 天，血清中 KGF 水平飙升（p < 0.01），但在第 25 天恢复至基线（p = 0.561）。体内 Ad-KGF 组的 KGF mRNA 水平显著增加（p = 0.037）。
扩展皮瓣模型适用于研究坏死性伤口。角质细胞生长因子可促进继发性坏死皮瓣伤口愈合，可通过腺病毒载体给予 KGF。
