In vivo microvascular regeneration in the various conditions and molecular expressions and regulations

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Obesity, hypertension, atherosclerosis obliterans (ASO)and diabetes mellitus (DM) are increasing as co-morbidities increasing among those who are undertaking free flap surgeries and digital re-plantations. In these co-morbidities, there are remarkable damages in the endothelial cells of these blood vessels and thus induced hypoxia and the oxidized stresses and ischemic-reperfusion injury are highly concerned. Even macroscopically successful re-anastomoses may lead to thrombosis afterward. Thus, the optimal microvascular environment was investigated with low-sensory and low-blood flow models.In the microvascular models, after ligating the femoral vessels and severing the saphenous nerves, the epigastric fascial flap of which the nutrient vessels are the superficial epigastric artery and veins, covered the ligated-vessels and severed-nerves by wrapping. The human derived mesenchymal stem cells, together with basic fibroblast growth factor (bFGF)were injected through the nutrient artery (the superficial epigastric artery)and then incubated for 10 minutes by clamping after the wrapped fascial flap was attached to the defects. The analysis of the nerve conduction velocity and tissue blood flows was temporally investigated. The ipsi-lateral 4-mm full-thickness paw skin defect was also compared among groups temporally.Also, clinically the head-and-neck surgery and extremities are sometimes difficult for microvascular surgical reconstructions, because spaspms and the differences of the diameters of the vessels are often experienced. As an alternative reconstructive modalities, especially severely damaged lower legs in the elderly population, the artificial dermis with cytokine (bFGF)were effective in wound coverage. In the analysis of quality of wounds, there is much better scar quality in bFGF-treated wounds from the immediately post-wounding as well as shortening the wound healing time.