AdVEGF165 gene transfer increases survival in overdimensioned skin flaps.

Giunta, RE; Holzbach, T; Taskov, C; Holm, PS; Konerding, MA; Schams, D; Biemer, E; Gansbacher, B

doi:10.1002/jgm.675

2005

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Titel:: AdVEGF165 gene transfer increases survival in overdimensioned skin flaps.
Dokumenttyp:: Journal Article; Article
Autor(en):: Giunta, RE; Holzbach, T; Taskov, C; Holm, PS; Konerding, MA; Schams, D; Biemer, E; Gansbacher, B
Abstract:: BACKGROUND: Vascular endothelial growth factor (VEGF) is a key regulator of angiogenesis. VEGF A also plays an important role in wound healing of the skin by promoting angiogenesis and by stimulating blood vessel growth. Therefore we tested the hypothesis that flap survival could be increased by the preoperative injection of AdVEGF(165). METHODS: We studied the effect of AdVEGF(165) in an overdimensioned ischemic random-pattern-flap model in the rat (n = 50) with a length-to-width ratio of 4 : 1. VEGF cDNA was administered in two concentrations of 5 x 10(8) plaque-forming units (pfU) and 1 x 10(9) pfU using a recombinant adenoviral vector. Recombinant virus was injected subdermally 7, 3 or 0 days prior to flap harvest for the lower concentration and 7 days prior for the higher concentration. Flap survival and necrosis were observed at day 7, the day the animals were sacrificed. RESULTS: Adenoviral gene transfer with VEGF(165) 3 and 7 days before flap harvest showed a significantly increased flap survival of 50% together with a significantly reduced necrosis (p < 0.01). Injection using a titer of 1 x 10(9) pfU 7 days prior to surgery increased flap survival even more, though failing to reach statistical significance compared to the lower concentration. VEGF protein concentration in the injected skin was significantly higher than in controls (p < 0.01). Flap perfusion was increased as well, demonstrated by indocyanine green (ICG) fluoroscopy (p < 0.001). CONCLUSIONS: Our results confirm the important role of VEGF(165) on angiogenesis in ischemic flaps. Indeed by injecting VEGF(165) at 3 to 7 days preoperatively in a concentration of 1 x 10(9) pfU our data show that length-to-width ratio for random-pattern-flaps could be increased from 2 : 1 to 3 : 1 and therefore may allow a wider range of applications of this simple flap technique.
Zeitschriftentitel:: J Gene Med
Jahr:: 2005
Band / Volume:: 7
Heft / Issue:: 3
Seitenangaben Beitrag:: 297-306
Sprache:: eng
Volltext / DOI:: doi:10.1002/jgm.675
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/15515117
Print-ISSN:: 1099-498X
TUM Einrichtung:: Institut für Experimentelle Onkologie und Therapieforschung; Lehrstuhl für Plastische Chirurgie und Handchirurgie (Prof. Machens)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Ehemalige Einrichtungen Institut für Experimentelle Onkologie und Therapieforschung 2005

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Plastische Chirurgie und Handchirurgie (Prof. Machens)Lehrstuhl für Plastische Chirurgie und Handchirurgie (Prof. Machens)2005