In spite of the common use of skin grafts and skin flaps in plastic and reconstructive surgery, serious complications still arise. The complete or partial necrosis that can occur in surgical flaps or grafts is due to prolonged tissue ischemia that compromises tissue blood flow. Prompt revascularization of the graft or flap by anastomoses and neovascularization is a major determinant of the success of graft/flap surgery.In this research, three angiogenic agents will be examined for their effects on skin-flap survival: (1) adenosine, a product of ischemic metabolism, (2) a low-molecular-weight, tumor-derived factor, and (3) a polypeptide angiogenesis factor, basic fibroblast growth factor. Test materials at various dosages will be applied to pedicle skin flaps on rats using infusion, suffusion, and/or subcutaneous injections that will be administered at the time of surgery, preoperatively, and/or postoperatively. The results of these studies will be analyzed with regard to effects on flap necrosis and survivability. Selected specimens will be examined histologically for effects on flap vasculature as well as on other features of the repair process. These Phase I studies will determine the feasibility of employing angiogenic agents in augmenting skin-flap survival. Favorable results will have relevance for skin-graft surgery as well as the treatment of other wound types.
Anticipated Results:Skin-graft and skin-flap surgery is broadly employed in plastic and reconstructive surgery. Up to 20 percent of surgical flaps or grafts suffer complete or partial necrosis, resulting in considerable expense in terms of suffering and hospital care. These studies seek a novel means for salvaging the failing skin graft or flap, thereby helping to eliminate a major problem plaguing surgeons.National Institute Of General Medical Sciences (NIGMS)
