ONLINE FIRST ORIGINAL ARTICLE Evaluating Revascularization and Flap Survival Using Vascular Endothelial Growth Factor in an Irradiated Rat Model

Abstract

Objective: To evaluate the role of vascular endothelial growth factor (VEGF) plasmid DNA (pDNA) in improving flap revascularization in a previously developed rat model. Our hypothesis was that the uptake and expression of VEGF pDNA in the wound bed would improve revascularization and flap viability. Design: Twenty-eight male Sprague-Dawley rats received a total dose of 40 Gy electron beam radiation to the ventral abdominal wall. After a recovery period, they underwent a ventral fasciocutaneous flap procedure with a 2-hour ischemia period. Group 1 (n=14) received topical VEGF pDNA, in vivo cationic polymer, and fibrin sealant. Group 2 (n=14) received topical cationic polymer and fibrin sealant only. Seven of the rats from each group underwent pedicle ligation at 8or14days.Theprimaryoutcomemeasurewaspercentage of flap revascularization 5 days after pedicle ligation. Results: Rats receiving VEGF pDNA had a significantly higher rate of flap revascularization (90.8 % vs 79.8%) after pedicle ligation at 14 days (P=.045). At 8 days, rats receiving VEGF pDNA (group 1) had an increased rate of flap revascularization (58.2 % vs 42.8%) that approached significance (P=.11). Conclusion: This study demonstrates the potential of VEGF pDNA to improve revascularization and flap viability in previously irradiated tissue