الفهرس 
Skin Flap PhysiologyOnly 14 pages are availabe for public view
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Abstract
Introduction: The use of flaps in reconstructive surgery is the mainstay in treatment of tissue defects and is essentially considered the starting point of plastic surgery. Although there are advances in reconstructive surgery, random pattern skin flap remains a common basic method of defect coverage. However, its main drawback is the uncertainty of distal flap survival. Flap necrosis usually occurs at its distal end and thus the defect area remains partially uncovered. This leads to unavoidable delay in healing and subsequent additional operations. Insufficient blood supply is considered an important cause of postoperative flap necrosis. Different techniques have been employed to enhance angiogenesis within areas of ischemia.
Mehods: 32 male albino wistar rats where used to study the role of adipose derived stem cells on random pattern skin flap survival. we applied the ASCs at three different timing, group A: (local injection of ASCs simultaneously with flap elevation), group B: (local injection of ASCs two days preoperatively) and group C: (ASCs were injected in the flap seven days preoperatively), In the control group (group D): the flap was injected with PBS at the time of flap elevation. Skin flap survival was evaluated on the seventh postoperative day through: percentage of flap survival, capillary density and VEGF expression.
Results: ASCs led to a statistically significant increase in skin flap viability when administered simultaneously with flap elevation or two days prior to flap elevation. This went along with the significant increase of capillary density and VEGF expression. However, the ASCs had no effect on flap survival when injected one week prior to flap elevation.
Conclusion: we demonstrate that the viability of random pattern skin flap can be enhanced by local ASCs administration simultaneously with flap elevation or two days prior to flap elevation. Their beneficial effect is attributed to paracrine secretion of growth factors such as VEGF which enhanced the skin flap vascularity. The angiogenic effect of ASCs can be maximized when the ASCs are injected at the time of flap elevation.