Use of adipose-derived mesenchymal stem cells to accelerate neovascularization in interpolation flaps
| Autor: | Hakki Izmirli, Bahar Muezzinoglu, Erdal Karaoz, Murat Şahin Alagöz, Serkan Isgoren, Guler Gamze Eren, Cansu Subasi, Huseyin Gercek, Ergin Yucel |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
Technetium Tc 99m Sestamibi medicine.medical_specialty Green Fluorescent Proteins Cell Culture Techniques Fluorescent Antibody Technique Neovascularization Physiologic Adipose-derived stem cell Cell Separation 030204 cardiovascular system & hematology Mesenchymal Stem Cell Transplantation Surgical Flaps Neovascularization 03 medical and health sciences 0302 clinical medicine Vascularity Image Processing Computer-Assisted Photography Medicine Animals Rats Wistar Interpolation flap business.industry Mesenchymal stem cell Graft Survival Angiography Histology Mesenchymal Stem Cells General Medicine Skin Transplantation Microradiography Capillaries Rats Plastic surgery Otorhinolaryngology Adipose Tissue Microangiography 030220 oncology & carcinogenesis Surgery Stem cell medicine.symptom Radiopharmaceuticals business Nuclear medicine |
| Popis: | Objective: Interpolation flaps are commonly used in plastic surgery to cover wide and deep defects. The need to, wait for 2 to 3 weeks until the division of the pedicle still, however, poses a serious challenge, not only extending treatment and hospital stay, but also increasing hospital expenses. To solve this problem, we have aimed to use the angiogenic potential of stem cells to selectively accelerate neovascularization with a view to increasing the viability of interpolation flaps and achieving early pedicle removal. Materials and Methods: A total of 32 rats were allocated to 2 groups as control (N = 16) and experiment (N = 16). The cranial flaps 6 × 5cm in size located on the back of the rats were raised. Then, a total suspension containing 3 × 10 adipose-derived mesenchymal stem cells (ADSC) tagged with a green fluorescent protein (GFP) was injected diffusely into the distal part of the flap, receiving bed, and wound edges. In the control group, only a medium solution was injected into the same sites. After covering the 3 × 5 cm region in the proximal part of the area where the flap was removed, the distal part of the flap was adapted to the uncovered distal area. The pedicles of 4 rats in each group were divided on postoperative days 5, 8, 11, and 14. The areas were photographed 7 days after the pedicles were released. The photographs were processed using Adobe Acrobat 9 Pro software (San Jose, CA) to measure the flap survival area in millimeters and to compare groups. Seven days after the flap pedicle was divided, the rats were injected with 250mCi Tc-99 mm (methoxy-isobutyl-isonitrie) from the penile vein, and scintigraphic images were obtained. The images obtained from each group were subjected to a numerical evaluation, which was then used in the comparison between groups. The flaps were then examined by histology to numerically compare the number of newly formed vessels. Neovascularization was also assessed by microangiography. In addition, radiographic images were obtained by mammography and evaluated quantitatively. Results: An evaluation of statistical results revealed a significant increase in the flap survival area of the group on stem cell treatment in comparison to the control group. In scintigraphic examinations, the rate of radioactive substance retention was significantly higher in the stem cell group, relative to the control group. Histopathologic examination showed that the capillary density in the stem cell group was higher than that in the control group. Green fluorescent protein had been used to label ADSC in the experiment and it was found by immun of luorescence staining that endothelial samples of control animals did not have GFP (+) cells, whereas all the animals in the experiment group had GFP (+) cells. The comparison of microangiographic images of the experiment and control groups demonstrated significantly elevated vascularity in the former, relative to the latter. Discussion: It has been established in the current study that ADSC injection worked well in speeding up the neovascularization of interpolated flaps and reducing the time of pedicle division. It seems possible to minimize the morbidity of interpolated skin flaps with mesenchymal stem cell therapy at an appropriate dose and for an appropriate length of time. Copyright © 2015 by Mutaz B. Habal, MD. |
| Databáze: | OpenAIRE |
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