Ding J-P, Chen B, Qian W-J, Bao S-W, Zhao H-Y
Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Beijing 100730, China.
Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 33 Ba-Da-Chu Road, Beijing 100144, China.
Br J Oral Maxillofac Surg. 2020 Jul;58(6):669-674. doi: 10.1016/j.bjoms.2020.03.027. Epub 2020 May 20.
Trans-territory perforator flaps are commonly used to reconstruct large defects of the soft tissues. The distal portion of the flap often becomes necrotic, however, as a result of the jeopardised vasculature of choke zone II. The trophic and vascular regenerative properties of bone marrow mesenchymal stem cells (BMSC) seemed to be a promising approach to prevent flaps becoming ischaemic. The purpose of our study is to evaluate the effects of BMSC on the survival of the three-territory perforator flap. The flap model was created based on the deep circumflex iliac vessel in rats. Eighteen rats were distributed, at random, into three groups. Immediately after the flaps were placed, groups were respectively given a single panniculus carnosus injection at choke zone II of either 1×10 (BMSCs), 1×10 (BMSCs) BMSC, or phosphate-buffered saline (PBS). On postoperative day seven, we assessed the gross view of the flap and survival. We also evaluated microvessels by histological examination and angiogenesis-related gene expression by quantitative real-time polymerase chain reaction. After high dosage of BMSC, the flap survival rate, diameter and density of microvessels, vascular endothelial growth factor (VEGF) and platelet endothelial cell adhesion molecule-1 (PECAM-1/CD31) levels were significantly higher in the BMSC treatment group than the control group. We therefore confirmed the positive effects of BMSC on the survival of multi-territory perforator flaps.
跨区域穿支皮瓣常用于修复大面积软组织缺损。然而，由于II型缺血带血管受损，皮瓣远端部分常发生坏死。骨髓间充质干细胞（BMSC）的营养和血管再生特性似乎是预防皮瓣缺血的一种有前景的方法。本研究的目的是评估BMSC对三区穿支皮瓣存活的影响。基于大鼠旋髂深血管建立皮瓣模型。18只大鼠随机分为三组。皮瓣放置后，分别在II型缺血带对三组大鼠的腹直肌进行单次注射，注射物分别为1×10（BMSCs）、1×10（BMSCs）BMSC或磷酸盐缓冲盐水（PBS）。术后第7天，评估皮瓣大体观及存活情况。我们还通过组织学检查评估微血管，并通过定量实时聚合酶链反应评估血管生成相关基因表达。高剂量BMSC处理后，BMSC治疗组皮瓣存活率、微血管直径和密度、血管内皮生长因子（VEGF）和血小板内皮细胞黏附分子-1（PECAM-1/CD31）水平均显著高于对照组。因此，我们证实了BMSC对多区穿支皮瓣存活具有积极作用。
