Artikel
Improvement of flap necrosis in a rat random skin flap model by in-vivo electroporation mediated HGF gene transfer
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Veröffentlicht: | 16. August 2017 |
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Introduction: Despite great understanding of underlying mechanisms for flap necrosis and advances in surgical techniques, flap necrosis remains a critical issue. In the present study, we investigated the efficacy of electroporation mediated HGF gene delivery to random dorsal skin flap (McFarlane) to accelerate wound healing and reduce flap necrosis.
Methods: Fifteen male Wistar rats (290–320 g) were randomly divided in three groups. (a) control group (n=5), underwent the surgery and received no gene transfer, group (b) received electroporation mediated HGF gene delivery 24 hours after the surgery as a treatment, and group (c) received electroporation mediated HGF gene delivery 24 hours before the surgery as prophylaxis (n=5). Planimetry, Laser Doppler imaging and immunohistochemistry were used to assess the efficacy of HGF gene therapy among the groups.
Results: Electroporation mediated HGF gene delivery significantly decreased flap necrosis percentage compared to the control group in prophylactic and treatment groups (p-value=0.0317, 0.0079, respectively) and increased significantly cutaneous perfusion compared to the control group (p-value=0.0317, 0.0159, respectively). Moreover, Spearman's rank correlation showed a significant negative correlation between flap necrosis percentage and Laser Index (p-value= 0.0297, r= -0.5679, respectively). Furthermore, significantly higher mean CD31+ vessel density was detected in treatment and prophylactic groups (p-value=0.0079, 0.0159, respectively). Additionally, quantitative image analysis revealed significantly higher HGF protein expression in groups b and c (p-value=0.0079 and 0.0079, respectively).
Conclusion: These findings suggested in-vivo electroporation mediated HGF gene delivery enhanced viability and vascularity of the ischemic skin flap.