plastische, reconstructieve en esthetische chirurgie - UZ Leuven

agent. Advances in cloning technology have enabledexpression of a recombinant PDGF, which hassubsequently been applied as an exogenous treatment ina number of animal models. Despite the inefficiency ofexogenous growth factor delivery, these studiesdemonstrated proof of concept that PDGF was able toinfluence wound healing favouraby and provided aplatform from which to launch strategies to deliver PDGFmore efficiently by gene therapy.VERHELLE N., VRANCKX J., VAN DEN HOF B., HEYMANSO.: Bone exposure in the leg: is a free muscle flapmandatory? Plast. Reconstr. Surg., 2005; 116(1): 170-177.Background: In lower leg defects with bone, hardware, orarticular exposure, a free tissue transfer is often the onlyvaluable option. However, in well-selected clinical cases,pedicled flaps are still indicated because they provide analternative for the more demanding and riskymicrosurgical procedure. The medial adipose-fascial flapof the leg represents an ideal local regional fascial flap.Methods: Twenty-two medial adipose-fascial flaps(performed in 21 patients) were reviewed retrospectivelyand compared with a series of 22 free gracilis flaps (22patients) selected out of 150 muscular free flaps forlower leg reconstruction. All patients with defects largerthan 40 cm, peripheral vascular disease, deep defects,and osteomyelitis were excluded in order to obtain thesame surgical indications in which the local medialadipose-fascial flap could have been used.Results: The overall surgical results were comparable,but more medical complications, a longer operative time,and a longer hospital stay were seen in the free musclegroup. Moreover, patients reconstructed with a medialadipose-fascial flap appeared to be more satisfied withthe aesthetic result of their reconstruction.Conclusions Muscle coverage is not mandatory to coverbone in the lower leg. The medial adipose-fascial flapcan provide a good alternative for free flap coverage.This flap seems to have fewer medical complications,requires a shorter operative time and hospital stay, andcan provide better aesthetic results than a free muscleflap.VRANCKX J.J., YAO F., PETRIE N., AUGUSTINOVA H.,HOELLER D., VISOVATTI S., SLAMA J., ERIKSSON E.: Invivo gene delivery of Ad-VEGF121 to full-thicknesswounds in aged pigs results in high levels of VEGFexpression but not in accelerated healing. Wound RepairRegen., 2005; 13(1): 51-60.We have previously reported that endogenous vascularendothelial growth factor (VEGF) concentration in olderpig wounds peaked later and at one-fourth the level ofyoung pigs. These data suggested that VEGF might playa major role in the healing of full-thickness wounds in the