Department of Plastic and Hand Surgery, Inselspital, Bern University Hospital, Bern, Switzerland.
Department for Biomedical Research, University of Bern, Bern, Switzerland.
PLoS One. 2018 Nov 26;13(11):e0207802. doi: 10.1371/journal.pone.0207802. eCollection 2018.
Distal flap necrosis is a frequent complication of perforator flaps. Advances in nanotechnology offer exciting new therapeutic approaches. Anti-inflammatory and neo-angiogenic properties of certain metal oxides within the nanoparticles, including bioglass and ceria, may promote flap survival. Here, we explore the ability of various nanoparticle formulations to increase flap survival in a rat model.
A 9 x 3 cm dorsal flap based on the posterior thigh perforator was raised in 32 Lewis rats. They were divided in 4 groups and treated with different nanoparticle suspensions: I-saline (control), II-Bioglass, III-Bioglass/ceria and IV-Zinc-doped strontium-substituted bioglass/ceria. On post-operative day 7, planimetry and laser Doppler analysis were performed to assess flap survival and various samples were collected to investigate angiogenesis, inflammation and toxicity.
All nanoparticle-treated groups showed a larger flap survival area as compared to the control group (69.9%), with groups IV (77,3%) and II (76%) achieving statistical significance. Blood flow measurements by laser Doppler analysis showed higher perfusion in the nanoparticle-treated flaps. Tissue analysis revealed higher number of blood vessels and increased VEGF expression in groups II and III. The cytokines CD31 and MCP-1 were decreased in groups II and IV.
Bioglass-based nanoparticles exert local anti-inflammatory and neo-angiogenic effects on the distal part of a perforator flap, increasing therefore its survival. Substitutions in the bioglass matrix and trace metal doping allow for further tuning of regenerative activity. These results showcase the potential utility of these nanoparticles in the clinical setting.
皮瓣远端坏死是穿支皮瓣的常见并发症。纳米技术的进步为治疗提供了新的方法。某些纳米颗粒中的金属氧化物（包括生物玻璃和氧化铈）具有抗炎和新生血管的特性，可能促进皮瓣存活。在这里，我们研究了各种纳米粒子配方在大鼠模型中增加皮瓣存活率的能力。
在 32 只 Lewis 大鼠中掀起了基于股后穿支的 9 x 3 cm 背侧皮瓣。将它们分为 4 组，并用不同的纳米粒子悬浮液处理：I-生理盐水（对照）、II-生物玻璃、III-生物玻璃/氧化铈和 IV-掺锌的锶取代生物玻璃/氧化铈。在术后第 7 天，进行皮瓣面积的测算和激光多普勒分析，以评估皮瓣存活率，并收集各种样本以研究血管生成、炎症和毒性。
与对照组（69.9%）相比，所有纳米粒子处理组的皮瓣存活面积都更大，其中 IV 组（77.3%）和 II 组（76%）达到统计学意义。激光多普勒分析的血流测量显示纳米粒子处理的皮瓣有更高的灌注。组织分析显示，在 II 组和 III 组中，血管数量增加，VEGF 表达增加。在 II 组和 IV 组中，细胞因子 CD31 和 MCP-1 减少。
生物玻璃基纳米粒子对穿支皮瓣的远端部位发挥局部抗炎和新生血管作用，从而增加其存活率。生物玻璃基质的取代和痕量金属掺杂允许进一步调整再生活性。这些结果展示了这些纳米粒子在临床环境中的潜在应用。
