Influence of flap prefabrication on seeding of subcutaneously injected mesenchymal stem cells in microvascular beds in rats

Ann Plast Surg. 2014 Aug;73(2):234-8. doi: 10.1097/SAP.0000000000000074.


Background: In this article, the authors investigated whether the prefabrication of an autologous pedicled flap by isolation from the surrounding with artificial skin substitutes would increase mesenchymal stem cell (MSC) seeding.

Methods: Mesenchymal stem cells were isolated from human umbilical cords and were cultured and characterized by fluorescence-activated cell sorting. Oxacarbocyanine and its green fluorescence emission were used to label the MSCs population.Sixteen adult Wistar rats were randomized in 4 groups (n = 4 animals per group). In group 1, a prefabricated groin flap (GF) with skin substitutes was harvested without cell injection; in group 2, 1 million MSCs were injected subcutaneously in the area corresponding to the GF without flap harvesting; in Group 3, a prefabricated GF with skin substitutes was harvested and 1 million MSCs were injected subcutaneously; and in Group 4, a prefabricated GF with skin substitutes was harvested and 2 million MSCs were injected subcutaneously. All procedures were performed bilaterally in each animal. Animals were sacrificed 2 weeks after the surgery. Flap viability was then assessed by clinical inspection and histology, and seeding of MSCs was observed.

Results: All flaps survived 2 weeks after the surgery. Oxacarbocyanine-labeled cells were found in all prefabricated flaps injected (Groups 3 and 4) in higher number in comparison with the group where subcutaneous injection without flap harvesting was performed (Group 2). This difference was statistically significant (P < 0.05).

Conclusions: Prefabricated skin flaps with skin substitutes may provide a useful vehicle for the implantation of MSCs to serve as an autologous microvascular bioscaffold.

Publication types

  • Evaluation Study

MeSH terms

  • Animals
  • Cord Blood Stem Cell Transplantation* / methods
  • Feasibility Studies
  • Graft Survival
  • Humans
  • Injections, Subcutaneous
  • Male
  • Microcirculation
  • Random Allocation
  • Rats
  • Rats, Wistar
  • Skin, Artificial*
  • Surgical Flaps / blood supply*
  • Surgical Flaps / pathology
  • Tissue Engineering / methods*
  • Tissue Scaffolds*