Desferrioxamine A Practical Method for Improving Neovascularization of Prefabricated Flaps
Desferrioxamine A Practical Method for Improving Neovascularization of Prefabricated Flaps
复制标题
去铁胺是一种改善预制皮瓣新生血管的实用方法
DOI：
10.1097/sap.0000000000000412
复制
发表时间：
2015
影响因子：
1.5
通讯作者：
Hao Lijun
中科院分区：
文献类型：
--
作者：
Li Bin;Li Hua;Jin Rui;Cheng Chen;Wang Jing;Zhu Hainan;Zan Tao;Li Qingfeng;Hao Lijun
背景预制皮瓣是修复大量复杂组织缺损的理想替代方案。然而，由于血液供应不可预测而导致坏死的风险是预制皮瓣应用的主要障碍。预制皮瓣的存活取决于血管载体和供体组织之间的新生血管形成。在此，我们提出铁螯合剂去铁胺（DFX）具有促进预制皮瓣新生血管形成的治疗作用。方法通过二阶段手术建立大鼠腹部预制皮瓣模型。将大鼠分为4组，如下：2组大鼠分别在手术第一阶段或第二阶段接受DFX治疗； 1组大鼠在第二次手术前1周接受延迟手术；最后一组作为空白对照。评估各组之间的皮瓣存活率和毛细血管密度。体外研究了DFX对真皮成纤维细胞的影响。结果手术第一阶段的去铁胺处理与空白对照相比大大提高了皮瓣的成活率。结果与延迟治疗产生的结果相似。血管计数结果与皮瓣存活率结果一致。在体外，DFX 治疗上调了真皮成纤维细胞中几种血管生成因子的表达水平。尽管如此，手术第二阶段的DFX治疗在治疗上是不利的。结论在血管载体植入前后应用DFX极大地促进了预制皮瓣的新生血管形成，但在皮瓣升起后在治疗上是不利的。
BackgroundPrefabricated flaps are an ideal alternative to repair massive and complex tissue defects. Nevertheless, the risk of necrosis due to unpredictable blood supplies is a major obstacle to the application of prefabricated flaps. The survival of a prefabricated flap depends on the neovascularization between the vascular carrier and the donor tissue. Here, we proposed that the iron chelator, desferrioxamine (DFX), owned therapeutic effects that promoted the neovascularization of prefabricated flaps.MethodsAn abdominal prefabricated flap model was created in rats via a 2-stage operation. The rats were allocated into 4 groups as follows: 2 groups of rats received DFX treatments during the first or the second stage of the operation, respectively; 1 group of rats received a delay procedure 1 week before the second operation; and the final group was used as a blank control. Flap survival rates and capillary densities were evaluated between groups. The influence of DFX on the dermal fibroblasts was also studied in vitro.ResultsDesferrioxamine treatment during the first stage of the operation greatly increased flap survival rate compared to the blank control. The results were similar to those produced by the delay treatment. The vessel count results were consistent with the flap survival rate findings. In vitro, DFX treatment up-regulated the expression levels of several angiogenic factors in the dermal fibroblasts. Nevertheless, DFX treatment during the second stage of the operation was therapeutically detrimental.ConclusionsThe application of DFX around the time of vascular carrier implantation greatly promoted neovascularization of prefabricated flaps, but was therapeutically detrimental after the flaps had been elevated.