Ankyra Medical Journal (AnkMJ), formerly known as the Journal of Translational and Practical Medicine, regularly publishes international quality issues in the field of Medicine in the light of current information.

EndNote Style
Original Article
Effect of adipose tissue-derived stromal vascular fraction on the viability of random-pattern skin flaps: an experimental study
Aims: Random pattern skin flaps are still widely used in plastic surgery. However, necrosis in distal flap sections resulting from ischemia is a serious problem, increasing the cost of treatment and hospitalization. The aim of this study was to test the effects of adipose tissue derived stromal vascular fraction (SVF) on random pattern skin flaps in rats.
Methods: In this experimental study conducted on Wistar rats, three groups were formed using the simple random sampling technique. Group 1 consisted of rats with a raised flap and a subcutaneous SVF injection. Group 2 comprised rats that underwent a flap operation with no additional treatment. Group 3 included rats with a raised flap and a subcutaneous saline injection. Tissue necrosis and level of survival area was detected with planimetric method and histopathologic examination was performed for detect of level of vascular density. On the 7th day post-operation, the viability assessment was calculated based on the ratio of the living flap area to the total flap area.
Results: The mean viability rate in Group 1 was higher compared to other groups, while there was no significant difference between Group 2 and Group 3 (Group 1 = 79.2 ± 4.9 % vs. Group 2 = 41.0 ± 5.9 % vs. Group 3= 39.2 ± 2.7 %, p < 0.001). The mean vascular densities of the flaps were higher in Group 1 compared to the other groups, while it were similar between Group 2 and Group 3 (Group 1 = 29.8 ± 1.2 vs. Group 2 = 8.4 ± 4.6 vs. Group 3= 9.3 ± 1.8, p < 0.001).
Conclusion: The use of fat tissue-derived SVF injections has been found to be advantageous in improving the survival of random pattern flaps, frequently utilized in plastic and reconstructive surgery.

1. Cai Y, Yu Z, Yu Q, et al. Fat extract improves random pattern skin flapsurvival in a rat model. Aesthet Surg J. 2019;39(12):NP504-NP514.
2. Jeon FHK, Varghese J, Griffin M, Butler PE, Ghosh D, Mosahebi A.Systematic review of methodologies used to assess mastectomy flapviability. BJS Open. 2018;2(4):175-184.
3. Guo J, Nguyen A, Banyard DA, et al. Stromal vascular fraction: aregenerative reality? Part 2: mechanisms of regenerative action. J PlastReconstr Aesthet Surg. 2016;69(2):180-188.
4. van Dongen JA, van Boxtel J, Uguten M, et al. Tissue stromal vascularfraction improves early scar healing: a prospective randomizedmulticenter clinical trial. Aesthet Surg J. 2022;42(7):NP477-NP488.
5. Gimble JM, Bunnell BA, Chiu ES, Guilak F. Concise review: adipose-derived stromal vascular fraction cells and stem cells: let&rsquo;s not get lostin translation. Stem Cells. 2011;29(5):749-754.
6. Han S, Sun HM, Hwang KC, Kim SW. Adipose-derived stromalvascular fraction cells: update on clinical utility and efficacy. Crit RevEukaryot Gene Expr. 2015;25(2):145-152.
7. Bora P, Majumdar AS. Adipose tissue-derived stromal vascular fractionin regenerative medicine: a brief review on biology and translation.Stem Cell Res Ther. 2017;8(1):145.
8. Katz AJ, Llull R, Hedrick MH, Futrell JW. Emerging approaches to thetissue engineering of fat. Clin Plast Surg. 1999;26(4):587-603.
9. Khouri R. Standardizing the dorsal rat flap. Surg Forum. 1986;37:590-591.
10. Nylander G, Lewis D, Nordstrom H, Larsson J. Reduction ofpostischemic edema with hyperbaric oxygen. Plast Reconstr Surg.1985;76(4):596-603.
11. Zheng YH, Yin LQ, Xu HK, Gong X. Non-invasive physical therapy assalvage measure for ischemic skin flap: a literature review. World J ClinCases. 2021;9(14):3227-3237.
12. Liu H, Liu J, Wu Y, et al. Analysis of the risk factors for free flapnecrosis in soft tissue reconstruction of the lower limbs. Orthop Surg.2023;15(6):1534-1540.
13. Kuo YR, Wang CT, Wang FS, Yang KD, Chiang YC, Wang CJ.Extracorporeal shock wave treatment modulates skin fibroblastrecruitment and leukocyte infiltration for enhancing extended skin-flap survival. Wound Repair Regen. 2009;17(1):80-87.
14. Berry CE, Le T, An N, et al. Pharmacological and cell-based treatmentsto increase local skin flap viability in animal models. J Transl Med.2024;22(1):68.
15. Hamou C, Callaghan MJ, Thangarajah H, et al. Mesenchymal stem cellscan participate in ischemic neovascularization. Plast Reconstr Surg.2009;123(2 Suppl):45S-55S.
16. Li DW, Liu ZQ, Wei J, Liu Y, Hu LS. Contribution of endothelialprogenitor cells to neovascularization. Int J Mol Med. 2012;30(5):1000-1006.
17. Capobianco S, Chennamaneni V, Mittal M, Zhang N, Zhang C.Endothelial progenitor cells as factors in neovascularization andendothelial repair. World J Cardiol. 2010;2(12):411-420.
18. Kirton JP, Xu Q. Endothelial precursors in vascular repair. MicrovascRes. 2010;79(3):193-199.
19. Zacchigna S, Papa G, Antonini A, et al. Improved survival of ischemic cutaneous and musculocutaneous flaps after vascular endothelialgrowth factor gene transfer using adeno-associated virus vectors. Am JPathol. 2005;167(4):981-991.
20. Nakagawa T, Sasaki M, Kataoka-Sasaki Y, et al. Intravenous infusion ofmesenchymal stem cells promotes the survival of random pattern flapsin rats. Plast Reconstr Surg. 2021;148(4):799-807.
21. De Becker A, Riet IV. Homing and migration of mesenchymal stromalcells: how to improve the efficacy of cell therapy? World J Stem Cells.2016;8(3):73-87.
22. Lu F, Mizuno H, Uysal CA, Cai X, Ogawa R, Hyakusoku H. Improvedviability of random pattern skin flaps through the use of adipose-derived stem cells. Plast Reconstr Surg. 2008;121(1):50-58.
23. Ichioka S, Kudo S, Shibata M, Ando J, Sekiya N, Nakatsuka T. Bonemarrow cell implantation improves flap viability after ischemia-reperfusion injury. Ann Plastic Surg. 2004;52(4):414-418.
24. Dong G, Wu H, Hu J, Teng L. Stromal vascular fraction promotesviability of co-grafted axial skin flaps in rats model. Aesthetic PlastSurg. 2022;46(4):1950-1963.
25. Oner C, Irmak F, Eken G, Oner BB, Karsidag SH. The effect of stromalvascular fraction in an experimental frostbite injury model. Burns.2023;49(1):149-161.
26. Hendawy H, Kaneda M, Yoshida T, et al. Heterogeneity of adiposestromal vascular fraction cells from the different harvesting sites inrats. Anat Rec. 2022;305(12):3410-3421.
27. DuttaRoy S. Transplantation of autologous endothelial cells andendothelial progenitor cells for angiogenesis. Dan Med Bull.2005;52(4):259.
Volume 3, Issue 1, 2024
Page : 19-23