Department of Plastic Surgery, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Department of Biological Chemistry, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Int Wound J. 2019 Dec;16(6):1471-1476. doi: 10.1111/iwj.13216. Epub 2019 Sep 5.
One of the most severe complications in aesthetic and reconstructive surgeries is the partial or total necrosis of a skin flap. In our experimental study, we demonstrated the use of adipose-derived stem cells in the increase of skin flap survival rates. Stem cells were isolated from the fat of Wistar rats and genetically modified to permanently produce a green fluorescent protein (GFP). Two random-pattern skin flaps (2 cm × 8 cm) were elevated on the dorsal area of the spine, and after being separated from the surgical wounds with a thin silicone sheet, they were placed back onto their original location. Then, the autologous GFP-producing cells were injected intradermally into the dorsal area of the rats. At the seventh day, after the implantation of the stem cells, a clinical and immunohistochemical control was performed. The fluorescence microscopy revealed green vascular formations, suggesting that autologous GFP stromal cells were converted into endothelial cells through neovascularization. In the control skin flaps, where no stromal cells were used, no fluorescence was observed. The statistical analysis showed significantly lower necrosis rates in the right-sided flaps (i.e., the flaps where adipose-derived stromal cells were injected) compared with the left-sided ones. Findings from our study demonstrate that adipose-derived stem cells play an important role in the improvement of skin flap survival. Neovascularization is an effective way of achieving it.
在美容和重建手术中，最严重的并发症之一是皮瓣的部分或完全坏死。在我们的实验研究中，我们展示了脂肪来源的干细胞在提高皮瓣存活率方面的应用。从 Wistar 大鼠的脂肪中分离出干细胞，并通过基因修饰使其永久产生绿色荧光蛋白（GFP）。在脊柱背部区域掀起两个随意皮瓣（2 cm×8 cm），并用薄的硅酮片将其与手术伤口分离，然后将其放回原来的位置。然后，将自体 GFP 产生细胞皮内注射到大鼠背部区域。在植入干细胞后的第 7 天，进行临床和免疫组织化学对照。荧光显微镜显示绿色血管形成，表明自体 GFP 基质细胞通过血管生成转化为内皮细胞。在未使用基质细胞的对照皮瓣中，未观察到荧光。统计分析显示，右侧皮瓣（即注射脂肪来源基质细胞的皮瓣）的坏死率明显低于左侧皮瓣。我们的研究结果表明，脂肪来源的干细胞在改善皮瓣存活率方面发挥着重要作用。血管生成是实现这一目标的有效途径。
