Nall A V, Brownlee R E, Colvin C P, Schultz G, Fein D, Cassisi N J, Nguyen T, Kalra A
Department of Otolaryngology, College of Medicine, University of Florida, Gainesville, USA.
Arch Otolaryngol Head Neck Surg. 1996 Feb;122(2):171-7. doi: 10.1001/archotol.1996.01890140057011.
To evaluate the effect of chronic irradiation on wound healing and random flap survival (FV), and the effect of transforming growth factor beta 1 (TGF-beta 1) in this setting using an animal model.
A randomized, controlled study with four groups of rats to study the effect of irradiation 4 months before surgical intervention. The effect of TGF-beta 1 on FV and wound healing also was evaluated in the irradiated and nonirradiated groups.
Ninety-five rats were available for evaluation. Group 1 (n = 10) was the control; group 2 (n = 28) received TGF-beta 1; group 3 (n = 28) received radiation therapy; and group 4 (n = 29) received radiation therapy and TGF-beta 1.
The irradiated groups received 15 Gy to their dorsal skin. Four months later all received McFarlane skin flaps. Groups 2 and 4 received topical TGF-beta 1, 4 micrograms, to the bed of the flap; groups 1 and 3 received saline. On postoperative day 7 all rats were evaluated for tensile strength and FV, and histologic staining with hematoxylin-eosin for collagen and TGF-beta 1 was done. The slides were evaluated in a "blinded" fashion.
Irradiation decreased tensile strength and FV, but not to a notable degree. Transforming growth factor beta 1 improved tensile strength in the irradiated (P = .04, Student's t test) and nonirradiated groups (P = .05, Student's t test). Transforming growth factor beta 1 also improved FV in all groups, but significantly in the irradiation plus TGF-beta 1 group (P = .001, Student's t test). The TGF-beta 1 group had the most mature collagen present at the wound edge. No qualitative difference was seen in the immunohistochemical staining for the four groups.
Transforming growth factor beta 1 improves wound healing and random FV in radiated and nonirradiated rat skin. Further study is needed to determine the radiation dose necessary to create an "impaired wound-healing model" in rats, and the optimum dose of TGF-beta 1 in this setting.
使用动物模型评估慢性辐射对伤口愈合和随意皮瓣存活（FV）的影响，以及转化生长因子β1（TGF-β1）在此情况下的作用。
一项随机对照研究，将四组大鼠用于研究手术干预前4个月辐射的影响。还在照射组和未照射组中评估了TGF-β1对FV和伤口愈合的影响。
95只大鼠可供评估。第1组（n = 10）为对照组；第2组（n = 28）接受TGF-β1；第3组（n = 28）接受放射治疗；第4组（n = 29）接受放射治疗和TGF-β1。
照射组的背部皮肤接受15 Gy辐射。4个月后，所有大鼠均接受麦克法兰皮瓣手术。第2组和第4组在皮瓣床局部应用4微克TGF-β1；第l组和第3组应用生理盐水。术后第7天，评估所有大鼠的抗张强度和FV，并进行苏木精-伊红染色以观察胶原蛋白和TGF-β1的组织学情况。玻片以“盲法”进行评估。
辐射降低了抗张强度和FV，但程度不显著。转化生长因子β1改善了照射组（P = 0.04，Student t检验）和未照射组（P = 0.05，Student t检验）的抗张强度。转化生长因子β1也改善了所有组的FV，但在照射加TGF-β1组中改善显著（P = 0.001，Student t检验）。TGF-β1组在伤口边缘有最成熟的胶原蛋白。四组的免疫组织化学染色未见定性差异。
转化生长因子β1可改善辐射和未辐射大鼠皮肤的伤口愈合及随意皮瓣存活。需要进一步研究以确定在大鼠中建立“伤口愈合受损模型”所需的辐射剂量，以及在此情况下TGF-β1的最佳剂量。
