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- 9-COMPARISON OF TWO WAYS OF ADMINISTRATION OF GROWTH FACTORS ( bFGF AND RGTA ) TO IMPROVE LATISSIMUS DORSI MUSCLE FLAP VASCULARIZATION AND TROPHICITY

Background: In recent clinical studies, growth factors have been used in both cardiovascular and plastic surgery. We showed in a previous study that local administration of bFGF (basic Fibroblast Growth Factor), VEGF (vascular endothelial growth factor) and RGTA (regenerating agent), at the Latissimus Dorsi Muscle (LDM)-epicardial interface in a model of dynamic cardiomyoplasty, improved the vascularization and the trophicity of the LDM. In this study we compared two different methods of growth factor administration. Methods: Right and left LDM flaps were performed in 24 sheep and left “in situ” in the thoracic wall. To create an ischemic environment, the serratus major was removed and the fascia was burned by electrocoagulation. Two different methods of growth factors administration were used: topically on the LDM surface through a multiperforated catheter for weekly administration over a 1-month period, or intramuscularly (IM) during the procedure. Basic fibroblast growth factor (n=12) and regenerating agent (n=12) a synthetic molecule which potentiates the effect of heparin binding growth factors, were administered. Each animal has been operated on both right and left sides: one side treated by one of the two factors, and the other as the control group. At three months, angiographic, histologic and histomorphometric studies were performed. Results: Hypervascularization due to the development of new vessels has been demonstrated by angiographic studies of the animals treated with growth factors. Histomorphometric and histologic studies showed a significant increase in the number of capillaries and arterioles (100 fields/muscle) in the groups treated with bFGF (IM: 661.4 ± 43.2, catheter: 631.6 ± 72.1) and RGTA (IM: 563.1 ± 80.6, catheter: 574.8 ± 44.3), in comparison with the control group: 388.5 ± 74.3. The atrophy score was lower in the group treated with bFGF (IM: 0.91 ± 0.14, catheter: 0.87 ± 0.23) and RGTA (IM: 0.85 ± 0.33, catheter: 1.13 ± 0.38) than in the control group (1.65 ± 0.37). Conclusions: RGTA and bFGF increase muscle vascularization and avoid muscle atrophy in an experimental model of LDM flap. A single intramuscular injection during surgery which is as efficient as weekly administration through a catheter, is the simpler and the better method for growth factor administration.