Fibroblast Growth Factor-1 vs. Fibroblast Growth Factor-2 in Ischemic Skin Flap Survival in a Rat Animal Model

BACKGROUND One of the main challenges in skin flap surgery is tissue ischemia and following necrosis. The present study compares the effects of fibroblast growth factors 1 and 2 on increasing cutaneous vasculature, improving ischemia, and preventing distal necrosis in ischemic skin flaps in rat model. METHODS Thirty rats were allocated into 3 groups (n=10) and 2×8 cm dorsal random-pattern skin flaps were raised after four daily subdermal injections of normal saline (control group), fibroblast growth factor 1 (FGF-1 group; 2.5 µg/day), or fibroblast growth factor 2 (FGF-2 group; 2.5 µg/day) at designated flap areas. Skin flap viability and number of blood vessels were evaluated on day 10 after elevation by planimetric analysis and histological examination. RESULTS It was shown that administrations of FGF-1 and FGF-2 significantly decreased the percentage of flap necrosis and improved the percentage of ischemic survivable area, compared to the control samples. Meanwhile, the differences between these factors in terms of preventing skin flap necrosis and improving ischemia were also significant. The number of visible blood vessel sections was also higher in FGF-1 and FGF-2 groups than in the control group. CONCLUSION These findings suggest that, while FGF-2 is still much more potent than FGF-1, treatment with either of these drugs could be very effective in increasing the survival of surgical flaps at risk (length to width ratio>3) in situations that other therapeutic options could not be considered.