Journal article
Augmentation of Adipofascial Flaps Using the Long-Term Local Delivery of Insulin and Insulin-Like Growth Factor-1
Plastic and reconstructive surgery (1963), Vol.106(2), pp.373-382
08/01/2000
DOI: 10.1097/00006534-200008000-00020
PMID: 10946936
Abstract
The adipofascial flaps currently described in the literature frequently lack the volume requirements for reconstructive goals. In this study, the authors examined the use of long-term local delivery of insulin and insulin-like growth factor-1 (IGF-1) using polylactic-coglycolic acid/polyethylene glycol (PLGA/PEG) microspheres to augment inguinal adipofascial flaps based on the inferior epigastric vessels in the rat. Two flap models, the island flap and the limited dissection flap, were used to demonstrate simultaneous treatment and pretreatment modalities, respectively. Experimental groups received 12.5 mg of insulin microspheres (carrying 1 IU of insulin) plus 12.5 mg of IGF-1 microspheres (carrying 2.5 μg of IGF-1). A group undergoing the operation only (no treatment with microspheres) and a group treated with blank microspheres (no growth factor) served as external controls for the surgical procedure and the drug delivery device, respectively. In all groups (n = 5 animals in each), the contralateral flap served as an internal control. Upon harvest on postoperative day 28, the insulin and IGF-1–treated flaps in both models weighed statistically more than the internal control flaps and the two external control flaps. Likewise, on gross inspection, the adipogenic growth factor–treated flaps had greater volumes than the internal control flap groups and both of the external control flap groups (operation only and blank microspheres). Other intergroup comparisons suggested the absence of a systemic insulin and IGF-1 effect on adiposity. A histomorphometric analysis suggested (1) that insulin and IGF-1 treatment does not alter flap cell composition and (2) that flap augmentation is secondary to the stimulation of cell proliferation and adipocytic differentiation rather than the hypertrophy of mature adipocytes. Further evidence in favor of cell proliferation and differentiation was the discovery of nonanatomic, ectopic fat islands on the pedicle sheath of the treated flaps and the lack of variation in cell size distribution among groups. The authors concluded that the long-term local delivery of insulin and IGF-1 with PLGA/PEG microspheres is an effective method of adipofascial flap augmentation; this method increases the number of mature adipocytes rather than increasing the size of preexisting cells.
Details
- Title: Subtitle
- Augmentation of Adipofascial Flaps Using the Long-Term Local Delivery of Insulin and Insulin-Like Growth Factor-1
- Creators
- Eser Yuksel - Baylor College of MedicineAdam B. Weinfeld - Rice UniversityRobert Cleek - Rice UniversityJohn Jensen - Rice UniversitySusanne Wamsley - Rice UniversityJacob M. Waugh - Rice UniversityMelvin Spira - Rice UniversitySaleh Shenaq - Rice University
- Resource Type
- Journal article
- Publication Details
- Plastic and reconstructive surgery (1963), Vol.106(2), pp.373-382
- DOI
- 10.1097/00006534-200008000-00020
- PMID
- 10946936
- ISSN
- 0032-1052
- eISSN
- 1529-4242
- Number of pages
- 10
- Language
- English
- Date published
- 08/01/2000
- Academic Unit
- Surgery
- Record Identifier
- 9984701654702771
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