Negative Pressure Wound Therapy Preconditioning Increases Survival Of Rabbit Skin Random-Pattern Flaps And Underlying Mechanism

Objective:To test whether Negative Pressure Wound Therapy preconditioning improves survival of random pattern skin flaps (over length flaps) and to confirm the role-of HIF-1/VEGF signaling pathway.Methods:Two 10.0cm×2.5cm random pattern flap model (overlength flaps) was dissected in the back of rabbit symmetrically. And the flaps on one side of the rabbit's backs were randomly arranged into control side, and the flaps on the other side served as the experimental side. In all flaps, the incision margin install the Negative Pressure Wound Therapy device. Intermittent negative pressure suction were given in experimental flaps only. At 7 days after operation, boundaries of the survival flap and the necrotic part was clear. The flap survival rate in both flaps was measured.3 samples with the size of 0.5cm×0.2cm×0.2cm were cut to test. A total of 30 samples were preserved. The expressions of flap histology and CD34 were observed mainly through HE stain and immunohistochemistry. Western-blot were used to compare the HIF-1? and CD34 expression. The expression of VEGF in the flaps was determined by ELISA analysis.Results:Experimental flap survival area (85.775 ± 10.798)% was significantly greater than the control flaps (54.956±19.649)%(P<0.05). The swelling, edema and congestion of experimental flaps were obviously mitigated compared with those control flaps. The Immunocytochemical staining showed that there were great of CD34 staining yellowed occupied in the experimental flaps. Western-blot detection of CD34 and HIF-1 a expression in the experimental flaps were higher than control flaps. EL1SA analysis expressed there were a higher level of VEGF in the experimental flaps.Conclusion:Negative Pressure Wound Therapy preconditioning improved survival of skin flaps by up the regulation of HIF-1/VEGF signaling pathway.