| Objective: To explore the effects of local injection of VEGF on the distal survival rate of the super long-wide proportion flap Methods: Choose 16 guinea pigs, no matter female and male, randomly devide them into two teams, each team have 8 guinea pigs. Remove hair in the area where the skin would be expanded. After 24 hours, the local PU was determinated, and then silicone rubber soft tissue expander was planted on the back. After 3 days, inject saline into the expander, every time inject 6ml, and the total number of injection times is 6. Then observe them 3 days, in the fourth day determinate the local PU and start skin flap made operation, the specification of the skin flap is 8 cm×2 cm, and inject 20ng / 100ml VEGF in the distal and middle piece of trail skin flap, the total volume is 200ng, however, in the control group PBS was injected by the same way. In the forth ,tenth and twelfth day of postoperative, PU value were detected in the proximal, middle and distal part of flap. At the same time ,in the twelfth day guinea pigs were put to death and taken specimen, and then PCNA and MVD were analysed by HE and SP methods .The database was created using SPSS11.5 and analysing the result by ANOVAResults: (1) Comparison of PU value between trail group and control group: there is no significant difference (P > 0.05) before the skin flap formed, but after the skin flap formed the PU in different period showed that the distal are shorter than the middle and the proximal, and among that the PU of the proximal is the maximum. Comparison PU of same period but different part in two groups, the results show that there is nostatistically significant difference in the proximal (P > 0.05) , but in the middle and distal parts, the PU value in the trial group is higher than the control group (P < 0.05). (2) HE staining: in two groups both show full thickness necrosis and obviously inflammation reaction, nuclei are decreased, atrophy and disruption. The living part of flap show a certain extent of edema, a large area granulation tissue hyperplasia and a great quantity of blood vessel formed , and at the same time the epidermis is very thin in two group. (3) PCNA detection: expression of PCNA in the trial group is stronger than that of control group, cellular proliferation^ 6%) is more active than that of control group(27%), especially in basal cell layer. In the granulation tissue there is a large quantity of new blood capillary, however in the control group positive expression cell and new blood capillary are fewer than trial group. ? Surgery observation: the living area in the trial group is obviously larger than that of control group(47% Vs 22%, p < 0.05), the middle and distal part of flap in the two groups have black scab, and the control group have more purulent secretions and permeation blood than trial group. (§) Comparison of MVD: the MVD in the trial group is larger than that of the control group( 39.12% Vs 25.37% ) , and the difference between two group is statistically significant.Conclusion: ? VEGF can promote cell proliferation and blood vessel endothelium cell hyperplasia. (2) Injection VEGF in the random expansion flap can promote the survival of the distal flap. |
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