J Reconstr Microsurg 2014; 30(01): 001-014
DOI: 10.1055/s-0033-1345429
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effects of Vascular Endothelial Growth Factor on Survival of Surgical Flaps: A Review of Experimental Studies

Taolin Fang
1   Division of Plastic Surgery, University of Mississippi Medical Center, Jackson, Mississippi
2   Department of Orthopaedics, Zhongshan Hospital Fudan University, Shanghai, China
,
William C. Lineaweaver
3   JMS Burn and Reconstructive Center, Crossgates River Oaks Hospital, Brandon, Mississippi
,
Michael B. Chen
1   Division of Plastic Surgery, University of Mississippi Medical Center, Jackson, Mississippi
,
Carson Kisner
1   Division of Plastic Surgery, University of Mississippi Medical Center, Jackson, Mississippi
,
Feng Zhang
1   Division of Plastic Surgery, University of Mississippi Medical Center, Jackson, Mississippi
› Author Affiliations
Further Information

Publication History

23 March 2012

03 February 2013

Publication Date:
28 May 2013 (online)

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Abstract

Partial or complete necrosis of skin flaps remains a significant problem in plastic and reconstructive surgery. Growth factors have shown promise in improving flap survival through increased angiogenesis and blood supply to the flap. Vascular endothelial growth factor (VEGF) is the most widely investigated and successful one. But the mechanisms of the effects are still not very clear. In the course of a series of experiments, we indicated that tissue survival of surgical flaps could be improved by both preoperative (sustained phase effect) and intraoperative (acute phase effect) application of VEGF. We reviewed both experimental and clinical investigations on the use of VEGF with surgical flaps to summarize the evidence of both phases of VEGF activity in promotion of flaps survival in detail. With the combinations of acute and sustained phases of effects, VEGF protein and gene, VEGF morphologic actions, and VEGF histochemical modulations suggest a pattern of VEGF activity that can be superimposed on classic descriptive mechanisms of tissue survival of flaps.