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Desferrioxamine

A Practical Method for Improving Neovascularization of Prefabricated Flaps

Li, Bin MD*†; Li, Hua PhD, MD*; Jin, Rui MD; Cheng, Chen MD; Wang, Jing MD; Zhu, Hainan PhD, MD; Zan, Tao PhD, MD; Li, Qingfeng PhD, MD*; Hao, Lijun PhD, MD

doi: 10.1097/SAP.0000000000000412
Transplantation Surgery and Research
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Background Prefabricated 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.

Methods An 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.

Results Desferrioxamine 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.

Conclusions The 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.

From the *Plastic and Aesthetic Center, The First Affiliated Hospital of Harbin Medical University, Harbin; and †Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China.

Received May 5, 2014, and accepted for publication, after revision, October 31, 2014.

Conflicts of interest and sources of funding: Supported by the National Natural Science Foundation of China (Grants 81230042 and 81201481) and the National Key Technology Research and Development Program of the Ministry of Science and Technology of China (Grant 2012BAI11B03).

Reprints: Qingfeng Li, PhD, MD, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Rd, Shanghai 200011, People’s Republic of China; Lijun Hao, PhD, MD, Plastic and Aesthetic Center, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Rd, Harbin 150001, People’s Republic of China. E-mail: dr.liqingfeng@shsmu.edu.cn; lijunhao368@163.com.

Bin Li and Hua Li contributed equally to the article and should be viewed as co–first authors.

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