RSS-Feed abonnieren
DOI: 10.1055/s-2007-981506
Shock Wave Therapy Reduces Necrotic Flap Zones and Induces VEGF Expression in Animal Epigastric Skin Flap Model
Publikationsverlauf
Publikationsdatum:
25. Mai 2007 (online)
ABSTRACT
The effect of extracorporeal shock wave (ESW) therapy on skin flap survival and growth factor expression was investigated in a rat model using epigastric skin flap. Treatment and control groups each contained 20 animals. ESW effectively enhanced epigastric skin flap survival by significant reduction of areas of necrotic zones. At day 7 after the operation, necrotic zones of 4.2% were found in the ESW-treated group compared with 18.3% in the control group (p < 0.01). Concomitantly, in tissue samples adjacent to the necrosis areas, increased vascular endothelial growth factor expression was observed in the ESW-treated animals (median 84.5%, range 57.4 to 94.5%) compared with the control group (median 46.7%, range 29.1 to 93.1%; p < 0.1). However, for expression of basic fibroblast growth factor, no difference was found between the two groups. The authors conclude that the success of the shock wave treatment may partly be due to modulation of growth factor expression.
KEYWORDS
Extracorporeal shock wave - skin flap - growth factors
REFERENCES
- 1 Zhang F, Yang F, Hu E C, Sones W, Lei M, Lineaweaver W C. Vascular endothelial growth factor gene therapy in improvement of skin paddle survival in a rat TRAM flap model. J Reconstr Microsurg. 2005; 21 391-396
- 2 Machens H G, Salehi J, Weich H et al.. Angiogenic effects of injected VEGF165 and sVEGFR-1 (sFLT-1) in a rat flap model. J Surg Res. 2003; 111 136-142
- 3 Huemer G M, Shasighi M, Meirer R, Debagge P, Piza-Katzer H, Gurunluoglu R. Adenovirus-mediated transforming growth factor-beta ameliorates ischemic necrosis of epigastric skin flaps in a rat model. J Surg Res. 2004; 121 101-107
- 4 Meirer R, Huemer G M, Oehlbauer M, Wanner S, Piza-Katzer H, Kamelger F S. Comparison of the effectiveness of gene therapy with vascular endothelial growth factor or shock wave therapy to reduce ischemic necrosis in an epigastric skin flap model in rats. J Plast Reconstr Aesthet Surg. 2007; 60 266-271
- 5 Wang C J, Wang F S, Yang K D et al.. Shock wave therapy induces neovascularization at the tendon-bone junction, a study in rabbits. J Orthop Res. 2003; 21 984-989
- 6 Padubidri A N, Browne Jr E. Modification in flap design of the epigastric artery flap in rats-a new experimental flap model. Ann Plast Surg. 1997; 39 500-504
- 7 Pellitteri P K, Kennedy T L, Youn B A. The influence of intensive hyperbaric oxygen therapy on skin flap survival in a swine model. Arch Otolaryngol Head Neck Surg. 1992; 118 1050-1054
- 8 Nall A V, Brownlee R E, Colvin C P. Transforming growth factor beta 1 improves wound healing and random flap survival in normal and irradiated rats. Arch Otolaryngol Head Neck Surg. 1996; 122 171-177
- 9 Hom D B, Assefa G. Effects of endothelial cell growth factor on vascular compromised skin flaps. Arch Otolaryngol Head Neck Surg. 1992; 118 624-628
- 10 Ishiguro N, Yabe Y, Shimizu T, Iwata H, Miura T. Basic fibroblast growth factor has a beneficial effect on the viability of random skin flaps in rats. Ann Plast Surg. 1994; 32 356-360
- 11 Rashid M A, Akita S, Razzaque M S. Coadministration of basic fibroblast growth factor and sucrose octasulfate (sucralfate) facilitates the rat dorsal flap survival and viability. Plast Reconstr Surg. 1999; 103 941-948
- 12 Lubiatowski P, Gurunluoglu R, Goldman C K, Skugor B, Carnevale K, Siemionow M. Gene therapy by adenovirus-mediated vascular endothelial growth factor and angiopoietin-1 promotes perfusion of muscle flaps. Plast Reconstr Surg. 2002; 110 149-159
- 13 O'Toole G, MacKenzie D, Lindeman R. Vascular endothelial growth factor gene therapy in ischaemic rat skin flaps. Br J Plast Surg. 2002; 55 55-58
- 14 Wang C J. An overview of shock wave therapy in musculoskeletal disorders. Chang Gung Med J. 2003; 26 220-232
- 15 Wang F S, Yang K D, Chen R F, Wang C J, Sheen-Chen S M. Extracorporeal shock wave promotes growth and differentiation of bone-marrow stromal cells towards osteoprogenitors associated with induction of TGF- β1. J Bone Joint Surg Br. 2002; 84 457-461
- 16 Meirer R, Huemer G M, Kamelger F S, Wanner S, Piza-Katzer H. Extracorporeal shock wave may enhance skin flap survival in an animal model. Br J Plast Surg. 2005; 58 53-57
- 17 Nissen N N, Polverini P J, Koch A E, Volin M V, Gamelli R L, DiPietro L A. Vascular endothelial growth factor mediates angiogenic activity during the proliferative phase of wound healing. Am J Pathol. 1998; 152 1445-1452
Florian S KamelgerM.D.
Department of Traumatology and Sports Medicine, Medical University Innsbruck
Anichstrasse 35, A-6020 Innsbruck, Austria