ABSTRACT
The purpose of this study was to determine the presence of growth factors and the
quality of angiogenic potential in the wound microenvironment in different types of
flaps in humans. The wound exudates from 23 flaps were processed for analysis of transforming
growth factor β1 (TGF-β1), epidermal growth factor (EGF), interleukin 1α (IL-1α),
platelet-derived growth factor-AB (PDGF-AB), vascular endothelial growth factor (VEGF),
and insulin-like growth factor (IGF-1) by enzyme-linked immunosorbent assay (ELISA)
or radio immuno assay (RIA). Angiogenic activity of wound fluid from latissimus flaps
was determined by thymidine incorporation in porcine microendothelial cells exposed
to various concentrations of wound fluid and control media. Angiogenic and matrix
growth factors were altered in a linear fashion during the wound-healing process.
Regression analysis provided evidence for decreasing levels of PDGF and EGF for latissimus
flaps. Also, statistically significant differences of growth factor levels were found
for paired comparison of flap types at different times after operation. Growth of
in-vitro endothelial cells was stimulated most by 10 percent wound fluid, compared to any
of the individual recombinant angiogenic factors or combinations of these factors.
The data suggest that vascularized tissue flaps will promote wound healing by providing
sufficient sources of growth factors in the wound environment. The particular type
of flap, i.e., muscle or fasciocutaneous flap, does not seem to have an impact on
growth-factor expression.
KEYWORDS
Angiogenesis - free flaps - growth factors
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Peter M VogtM.D. Ph.D.
Department of Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Podbielskistr
380, D-30659 Hannover, Germany
