gms | German Medical Science

132. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

28.04. - 01.05.2015, München

The hemodynamically stimulated and in vivo vascularized soft tissue free flap enables closure of large defects in rats

Meeting Abstract

  • Volker Schmidt - BG-Unfallklinik Ludwigshafen - Universität Heidelberg, Department for Hand-, Plastic- and Reconstructive Surger, Ludwigshafen, Deutschland
  • Nico Leibig - BG-Unfallklinik Ludwigshafen - Universität Heidelberg, Department for Hand-, Plastic- and Reconstructive Surger, Ludwigshafen, Deutschland
  • Johanna O. Wietbrock - BG-Unfallklinik Ludwigshafen - Universität Heidelberg, Department for Hand-, Plastic- and Reconstructive Surger, Ludwigshafen, Deutschland
  • Amir Khosrow Bigdeli - BG-Unfallklinik Ludwigshafen - Universität Heidelberg, Department for Hand-, Plastic- and Reconstructive Surger, Ludwigshafen, Deutschland
  • Ulrich Kneser - BG-Unfallklinik Ludwigshafen - Universität Heidelberg, Department for Hand-, Plastic- and Reconstructive Surger, Ludwigshafen, Deutschland

Deutsche Gesellschaft für Chirurgie. 132. Kongress der Deutschen Gesellschaft für Chirurgie. München, 28.04.-01.05.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. Doc15dgch460

doi: 10.3205/15dgch460, urn:nbn:de:0183-15dgch4600

Published: April 24, 2015

© 2015 Schmidt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Introduction: Early and reliable closure of large and full thickness defects is critical to restore function and to prevent severe infective complications. Nowadays, microsurgical transfer of vascularized tissue allows a reconstructive treatment following extensive tumour resection, severe trauma or congenital defects.

Material and methods: To circumvent the donor site morbidity and limitation associated with conventional flaps we introduced a hemodynamically stimulated and in vivo vascularized soft tissue free flap. In this model a grafted venous vessel is interposed between the femoral artery and vein in the rat to create an arteriovenous shunt. In such grafted vessels embedded in a Matriderm© matrix, angiogenesis occurs without the need of exogenous addition of angiogenic factors. We previously demonstrated that the substantial increase in flow is required to initiate angiogenesis within the graft. To evaluate the clinical reliability of the intrinsically vascularized soft tissue flap we established a full thickness scapula defect model in the microsurgical research unit of the BG Unfallklinik Ludwigshafen that permits vascular connectivity.

Conclusion: In summary, the scapula defect model gained standardized wounds that required vascularized coverage for an adequate wound repair. At this early stage the in vivo vascularized soft tissue free flap was superior to the non-vascularized approaches and appears to be comparable to the conventional free flap control in terms of reliable defect closure.