Effect of vascular endothelial growth factor (VEGF) on survival of random extension of axial pattern skin flaps in the rat.

Current evidence suggests that neovascularization is mediated by a wide range of angiogenic growth factors. Vascular endothelial growth factor (VEGF) appears to be one of the most important angiogenic factors in vivo. The aim of this project was to evaluate the efficacy of VEGF in augmentation of blood supply to skin flaps. Epigastric skin flaps were raised in 16 Sprague-Dawley male rats. In group A (N = 8), 5 micrograms of VEGF was injected into the epigastric artery after flap elevation. In the control, group B (N = 8), the artery was injected with saline. On the seventh day, the rats were photographed and the digital images were analyzed using imaging software (Image-Pro Plus 1.2). The blood flow in the flaps was measured with a percutaneous laser Doppler probe at specific locations. Histological studies of the flaps were done. Results showed that the mean percentage surviving flap area was 71.9% in group A and 53.7% in the control group, which is statistically significant (p < 0.001). Histological examination revealed increased density of the capillaries in the flaps treated with VEGF when compared to the control group. We believe the increase in skin survival is due to angiogenesis induced by the VEGF.