背景:在重建手术中,局部皮瓣可能发生组织坏死或部分皮瓣丢失,特别是在先前的照射后,这在许多肿瘤实体中可能是必要的。干细胞的应用似乎有望改善皮瓣灌注,并且可能是优化皮瓣存活的可能解决方案。
方法:20只大鼠接受双侧随机型筋膜皮瓣的采集。右侧皮瓣在手术前4周接受了20Gy电离辐射,而左皮瓣作为非照射控制。皮瓣收获后,四种不同的干细胞混合物(5×106ASC,ASC-HUVEC,MSC,MSC-HUVEC)使用1mL纤维蛋白胶作为递送载体在右和左皮瓣下施用。临床检查皮瓣大小及其坏死面积。手术两周后,HE染色和免疫组化染色CD68和ERG,以及PCR分析(白细胞介素6,HIF-1α和VEGF),被执行了。
结果:ASCs的应用,与无细胞组相比,ASC-HUVEC和MSC导致较低数量的CD68染色的细胞。与MSC和先前未处理的细胞组相比,ASC组中Hif1α的表达更高。用MSCs和MSCs-HUVEC治疗可防止该系列中的皮瓣收缩。
结论:ASCs的应用,MSC和ASC-HUVEC显示具有抗炎作用。用MSCs和MSCs-HUVECs治疗可以防止皮瓣的早期收缩。
BACKGROUND: In reconstructive surgery, local flaps might develop tissue necrosis or partial flap loss especially after previous irradiation, which may be necessary in many tumor entities. The application of stem cells seems promising to improve flap perfusion and might be a possible solution to optimize flap survival.
METHODS: Twenty rats received harvesting of bilateral random pattern fasciocutaneous flaps. The right flaps received 20 Gy ionizing radiation 4 weeks prior to the surgery, while the left flaps served as the non-irradiated control. After flap harvest, four different stem cell mixtures (5 × 106
ASC,
ASC-HUVEC, MSC, MSC-HUVEC) were applied under both right and left flaps using 1 mL fibrin glue as the delivery vehicle. Flap size and its necrotic area were examined clinically. Two weeks after the surgery, HE staining and immunohistochemical staining for CD68 and ERG, as well as PCR analysis (Interleukin 6, HIF-1α and VEGF), were performed.
RESULTS: Application of ASCs, ASCs-HUVECs and MSCs resulted in a lower number of CD68-stained cells compared to the no cell group. The expression of Hif1α was higher in the
ASC group compared to those in the MSC and previously treated no cell groups. Treatment with MSCs and MSCs-HUVECs prevented shrinking of the flaps in this series.
CONCLUSIONS: Application of ASCs, MSCs and ASCs-HUVECs was shown to have an antiinflammatory effect. Treatment with MSCs and MSCs-HUVECs can prevent early shrinking of the flaps.