Plastic Surgery Research Council
Members Only  |  Contact  |  PSRC on Facebook
PSRC 60th Annual Meeting

Back to Annual Meeting Program


The Impact of Deferoxamine on Vascularity and Soft Tissue Biomechanics in a Rat TRAM Flap Model
Alexander F. Mericli, M.D., Anusuya Das, Ph.D., Pamela Rodeheaver, B.S., George Rodeheaver, Ph.D., Kant Y. Lin, M.D..
University of Virginia, Charlottesville, VA, USA.

Purpose: Flap ischemia is a worrisome complication in reconstructive surgery and can lead to partial or total flap necrosis, tissue fibrosis and stiffness, infection, and a poor aesthetic result. Deferoxamine (DFX) is an FDA-approved iron chelating medication which has also been shown to increase the growth of new blood vessels through its ability to upregulate HIF-1a, a key transcription factor for several genes important for angiogenesis. DFX has been shown to augment bone vascularity, however its use in soft tissue has not been fully evaluated. We hypothesize that the application of DFX will result in improved vascularity and tissue elasticity in a rat TRAM flap model.
Methods: Two groups of Sprague-Dawley rats (n =10) underwent a right pedicled TRAM flap. Twenty-one days after surgery, the experimental group (n = 5) was treated with deferoxamine injected subcutaneously into the flap every other day for ten days. The control group underwent TRAM flap creation only. Ten days after the last dose of deferoxamine the rats were perfused and imaged with micro computed-tomographic angiography (mCTA). Vascular radiomorphometrics were calculated and statistical comparison was conducted. Flap tissue biomechanics were assessed in both groups using an Instron tensiometer. Stress-strain, creep, and stress relaxation curves were created. Histologic analysis was performed using H&E and Verhoeff Van Gieson stains.
Results: mCTA demonstrated significantly increased vascularity in the DFX TRAM flaps compared to the control (Figure 1). Similarly, histologic analysis revealed an increased number of blood vessels per high-powered field (vHPF) in the DFX flaps (3.24 vHPF - DFX vs 2 vHPF - control; p = .03). The DFX flaps demonstrated greater creep and stress-relaxation compared to control, findings consistent with a more elastic tissue (Figure 2). Additionally, the Verhoeff Van Gieson stain for elastin indicated a greater elastin content in the dermis of the DFX flaps compared to control.
Conclusions: These results suggest that the subcutaneous administration of DFX is associated with increased TRAM flap vascularity, as measured by mCTA and histologic analysis. Additionally, flaps that received DFX demonstrated greater elasticity and higher elastin content.


Back to Annual Meeting Program