J Korean Soc Plast Reconstr Surg.  2009 Jan;36(1):1-10.

Improvement of the Inferior Epigastric Artery Flap Viability Using Adenovirus-mediated VEGF and COMP-angiopoietin-1

• Yoo EK
• Son D
• Kim HT
• Lee IK
• Choi T
• Kim J
• Han K

Abstract

PURPOSE
Partial necrosis of skin flaps remains a substantial problem in reconstructive surgery. We investigated the potential use of an adenovirus vector encoding the VEGF, COMP-angiopoietin-1 gene in an attempt to promote the viability of the inferior epigastric artery flap in a rat model.
METHODS
Three by six cm lower abdominal transverse skin flaps, supplied only by the left inferior epigastric artery, were designed. After skin flap elevation, the adenovirus VEGF and adenovirus COMP-angiopoietin-1 were injected into the distal portion of the flap, which has a high tendency of developing flap ischemia. Control animals were injected with the same volume of normal saline. On 3, 7 and 14 days after the flap elevation, the flap survival and vascularization were assessed using Visitrak digital(R), CD31 immunohistochemistry in addition to evaluating the general histological characteristics.
RESULTS
There was a significant increase in the mean percentage of flap viability by 89.8%, 91.1% and 94.8% in flaps transfected with adenovirus VEGF, COMP- angiopoietin-1, coadministraion of VEGF and COMP- angiopoietin-1 at seven days, and by 95.6%, 94.8% and 96.3% at 14 days. Histological assessment revealed that there were more blood vessels formed after adenovirus with VEGF, COMP-angiopoietin-1 or VEGF plus COMP- angiopoietin-1 than with adenovirus Lac Z.
CONCLUSION
The results of this study suggest that adenovirus-mediated VEGF, COMP-angiopoietin-1 gene therapy, promote therapeutic angiogenesis in patients that undergo reconstructive procedures. Key Words:

Keyword

VEGF; Angiopoietin; Gene therapy; Flap

MeSH Terms

Adenoviridae
Angiopoietin-1
Animals
Blood Vessels
Epigastric Arteries
Genetic Therapy
Humans
Immunohistochemistry
Ischemia
Necrosis
Rats
Skin
Vascular Endothelial Growth Factor A
Angiopoietin-1
Vascular Endothelial Growth Factor A