Enhancement of Ischemic Flap Survival by Prefabrication with Transfer of Exogenous PDGF Gene

Our laboratory has been studying the effect of aspirin, given alone or in combination with other medications, on random pattern skin flaps. We have consistently found that preoperative aspirin in high doses (200 mg/kg) increases flap survival, apparently as a result of its ability to modify the inflammatory reaction and/or direct vasodilatation, and not as a consequence of antiaggregation of platelets. In an effort to further elucidate how this effect is modulated, we designed this experiment in which we gave aspirin after the operative procedure to simulate an acute clinical surgical problem such as a failing or ischemic flap. Our results failed to show any difference between the rats that received postoperative aspirin and the untreated control group. It would appear that aspirin given postoperatively is not able to counteract the noxious elements that affect flap survival. This work indicates an important relationship between the timing of administration and the beneficial effects of aspirin. By investigating fully the mechanism whereby aspirin is able to improve flap survival, we hope to isolate this mechanism so an alternative pharmacological agent, safer than aspirin, can be found for clinical use.

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Activated Protein C Improves Ischemic Flap Survival and Modulates Proangiogenic and Antiinflammatory Gene Expression

Plastic & Reconstructive Surgery ◽

10.1097/prs.0b013e318196b87f ◽

2009 ◽

Vol 123 (2) ◽

pp. 502-515 ◽

Cited By ~ 6

Author(s):

Michael Bezuhly ◽

Steven F. Morris ◽

Ridas Juskevicius ◽

R William Currie ◽

Kenneth A. West ◽

...

Keyword(s):

Gene Expression ◽

Protein C ◽

Activated Protein C ◽

Flap Survival ◽

Ischemic Flap

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89: COMPARISON OF AAV-DS-VEGF AND AAV-SS-VEGF: EFFICACY OF IN VITRO TRANSGENE EXPRESSION AND IN VIVO ISCHEMIC FLAP SURVIVAL

Plastic & Reconstructive Surgery ◽

10.1097/01.prs.0000396776.20163.34 ◽

2011 ◽

Vol 127 ◽

pp. 53

Author(s):

PY Liu ◽

B Avanessian ◽

QZ Ma ◽

H Durfee ◽

YQ Tang ◽

...

Keyword(s):

Transgene Expression ◽

Flap Survival ◽

Ischemic Flap

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Improved Skin Flap Survival After Local Heat Preconditioning in Pigs

Yearbook of Plastic and Aesthetic Surgery ◽

10.1016/s1535-1513(08)70235-2 ◽

2007 ◽

Vol 2007 ◽

pp. 267-268

Author(s):

W.L. Garner

Keyword(s):

Skin Flap ◽

Local Heat ◽

Flap Survival ◽

Skin Flap Survival

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Chemically Modified SDF-1α mRNA Promotes Random Flap Survival by Activating the SDF-1α/CXCR4 Axis in Rats

SSRN Electronic Journal ◽

10.2139/ssrn.3506124 ◽

2019 ◽

Author(s):

Zucheng Luo ◽

Yujie Bian ◽

Gang Zheng ◽

Hui Jing Wang ◽

Bingqian Yan ◽

...

Keyword(s):

Flap Survival ◽

Chemically Modified ◽

Cxcr4 Axis

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Survival of a Free Jejunal Flap with Early Venous Obstruction

Plastic Surgery Case Studies ◽

10.1177/2513826x211022486 ◽

2021 ◽

Vol 7 ◽

pp. 2513826X2110224

Author(s):

Ryo Yamochi ◽

Toshiaki Numajiri ◽

Syoko Tsujiko ◽

Hiroko Nakamura ◽

Daiki Morita ◽

...

Keyword(s):

Head And Neck ◽

Oral Intake ◽

Superior Thyroid Artery ◽

Head And Neck Reconstruction ◽

Venous Obstruction ◽

Flap Survival ◽

Flap Transfer ◽

Neck Reconstruction ◽

Free Jejunal Flap ◽

Vascular Status

Free jejunal flap transfer is common in head and neck reconstruction, but necrosis remains a complication. A 77-year-old man underwent total pharyngo-laryngo-esophagectomy, bilateral neck dissection, and free jejunal flap transfer. We anastomosed 3 arteries (facial, transverse cervical, and superior thyroid) and 1 vein (jejunal) because the recipient site’s arterial status was poor. On day 2, ultrasonography and visualization revealed that the anastomosed vein was obstructed in the cranial jejunum but the remainder was viable. The region recovered by day 7 and the patient began oral intake on day 30. Ultrasonography revealed that the anastomosed jejunal vein showed no waveform, the facial and transverse cervical arteries showed arterial waveforms, and the superior thyroid artery showed a retrograde venous waveform. The flap had survived because the blood exited through the superior thyroid artery and vein. Thus, additional vascular and arterial anastomoses are options for free flap survival if the vascular status is poor.

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