Effects of insulin-like growth factor-1 on random pattern skin flap survival in rats.

Nurten Turhan Haktanır,Mehmet Fatih Bozkurt,Yavuz Demir,Güray Yılmaz

doi:10.1590/s0102-865020160080000003

Abstract

To investigate the effects of pharmacological delay with insulin-like growth factor-1 (IGF-1) on skin flap survival. Thirty Sprague-Dawley rats were submitted to dorsal skin flap (3x9 cm). Seven days before the surgery, the animals were subdivided into three groups of 10 rats. In group 1 (controls), no injection was done. Seven days before the elevation, saline had been injected to the marked skin flap area in group 2 (sham group), and group 3 (experimental group) underwent a pharmacological delay with subcutaneous IGF-1 injections. On the seventh postoperative day, flap area was analyzed for survival. Tissue samples were obtained for histological and biochemical evaluations. Survival rates were 43.55 ± 16%, 21.40 ± 8%, and 43.12 ± 14% in groups 1, 2, and 3, respectively. Differences between group 2 and other groups were statistically significant. No significant difference was detected between all three groups for tissue or plasma vascular endothelial growth factor (VEGF) levels. There was no significant histological difference between groups. Although a single injection of insulin-like growth factor-1 (IGF-1) did not significantly increase flap survival, its wound healing features are still encouraging and further meticulously planned studies, especially with repeated applications or controlled-release methods, and combinations with binding protein are required.

Highlights

One of the basic practices in plastic and reconstructive surgery is reparation of tissue defects caused by trauma, tumor, congenital abnormalities, or other incidents
Thirty Sprague-Dawley rats ranging 250-300 grams were employed in the research
Standard room conditions were maintained with a temperature of 24°C, 12 hours illuminated - 12 hours dark conditions and equal cage sizes

Summary

Introduction

One of the basic practices in plastic and reconstructive surgery is reparation of tissue defects caused by trauma, tumor, congenital abnormalities, or other incidents. The best functional and aesthetic results are achieved using flaps for this purpose. Flaps are classified as two subgroups according to the vascular supply: random-pattern skin flaps (supplied by subdermal-dermal plexus) and axial-pattern skin flaps (supplied by a direct cutaneous artery and vein located in subcutaneous tissue). Extending flap survival and decreasing amount of flap necrosis has been important subjects in surgical research. Surgical delay is the mostly used method for lessening the flap necrosis. Main disadvantages of delay are multiple interventions and long hospital stay. Many agents have been discussed for a single step delay process[1]

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