Abstract
Trans-territory perforator flaps are commonly used to reconstruct large defects of
the soft tissues. The distal portion of the flap often becomes necrotic, however,
as a result of the jeopardised vasculature of choke zone II. The trophic and vascular
regenerative properties of bone marrow mesenchymal stem cells (BMSC) seemed to be
a promising approach to prevent flaps becoming ischaemic. The purpose of our study
is to evaluate the effects of BMSC on the survival of the three-territory perforator
flap. The flap model was created based on the deep circumflex iliac vessel in rats.
Eighteen rats were distributed, at random, into three groups. Immediately after the
flaps were placed, groups were respectively given a single panniculus carnosus injection
at choke zone II of either 1 × 105 (BMSCslow), 1 × 106 (BMSCshig) BMSC, or phosphate-buffered saline (PBS). On postoperative day seven, we assessed
the gross view of the flap and survival. We also evaluated microvessels by histological
examination and angiogenesis-related gene expression by quantitative real-time polymerase
chain reaction. After high dosage of BMSC, the flap survival rate, diameter and density
of microvessels, vascular endothelial growth factor (VEGF) and platelet endothelial
cell adhesion molecule-1 (PECAM-1/CD31) levels were significantly higher in the BMSC
treatment group than the control group. We therefore confirmed the positive effects
of BMSC on the survival of multi-territory perforator flaps.
Keywords
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Article info
Publication history
Published online: May 20, 2020
Accepted:
March 30,
2020
Identification
Copyright
© 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
