2023, Vol. 27 ›› Issue (12): 1914-1919

Vascular regeneration of the prefabricated flap using expanded polytetrafluoroethylene membrane barrier material

Song Peng1, Liu Yizheng1, Lei Zhen2   

Abstract: BACKGROUND: Although prefabricated flap is an ideal method to repair composite defects, the risk of flap necrosis is still an urgent problem to be solved. Therefore, promoting the revascularization of prefabricated flap can improve its survival rate and reduce complications.
OBJECTIVE: To investigate the effect of expanded polytetrafluoroethylene membrane barrier material on vascular regeneration of prefabricated flap in rats.
METHODS: Thirty SD rats were randomly divided into three groups with 10 rats in each group: control group, silica gel membrane group and expanded polytetrafluoroethylene group. In the silica gel membrane group and expanded polytetrafluoroethylene group, bilateral back arbitrary flaps (7.5 cm long and 1.5 cm wide) were prefabricated by the barrier delay method. Silica gel membrane and expanded polytetrafluoroethylene membrane were implanted under the flap. In the control group, the flap was prefabricated with non-barrier delay method, and the flap was directly sutured in situ without barrier under the flap. The vascular regeneration was observed after operation. At 14 days after operation, the flap tissue was stained with hematoxylin and eosin. Immunohistochemistry for vascular endothelial growth factor and CD34 was utilized to detect the activity of superoxide dismutase and the level of malondialdehyde.
RESULTS AND CONCLUSION: (1) At 2 weeks after operation, the flap was cut again. In the silica gel membrane group, some rats had axial vascular regeneration and one rat had silicone curl. All rats in the expanded polytetrafluoroethylene group had obvious axial vessels. (2) The microvessel density of expanded polytetrafluoroethylene group was significantly higher than that of control group and silica gel membrane group (P < 0.05). The number of CD34 positive vessels in expanded polytetrafluoroethylene group was significantly higher than that in the control and silica gel membrane groups (P < 0.05). The integral absorbance of vascular endothelial growth factor protein in the expanded polytetrafluoroethylene group was significantly higher than that in the control and silica gel membrane groups (P < 0.05). (3) The activity of superoxide dismutase in the expanded polytetrafluoroethylene group was higher than that in the silica gel membrane group and control group (P < 0.05), and the level of malondialdehyde was lower than that in silica gel membrane group and control group (P < 0.05). (4) Using expanded polytetrafluoroethylene membrane as barrier delay material can promote the angiogenesis of prefabricated flap in rats, reduce oxidative stress, and improve the survival rate of the flap.  
Key words: expanded polytetrafluoroethylene, silicone rubber, prefabricated flap, vascular regeneration, oxidative stress