D. M. Irizarry1, J. Flacco1, C. P. Blackshear1, G. C. Gurtner1, M. T. Longaker1,2, D. C. Wan1 1Stanford University Medical Center,Hagey Laboratory For Pediatric Regenerative Medicine,Palo Alto, CA, USA 2Stanford University Medical Center,Institute For Stem Cell Research And Regenerative Medicine,Palo Alto, CA, USA
Introduction:
Radiation therapy induces hypovascularity causing the skin to become fibrotic and soft tissue to atrophy. Fat grafting has been shown to improve the quality of irradiated skin, but volume retention of the graft is significantly decreased. Desferal, an FDA-approved iron-chelating medication, has been shown to increase angiogenesis, and treatment of irradiated sites with this compound may reduce radiation induced ischemia and enhance fat graft survival.
Methods:
Immunocompromised mice underwent 30-Gy external beam irradiation of the scalp. Four weeks later, mice either received seven desferal treatments (1mg in 100ul) or saline subcutaneously to the irradiated area. Laser Doppler analysis (LDA) was recorded prior to irradiation, following irradiation, and following each treatment. Human fat grafts were then injected in the subcutaneous plane of the scalp and volume retention measured by CT scan over 8 weeks. Finally, skin and fat samples were evaluated histologically.
Results:
After 4 treatments with desferal, a significant increase in microvasculature was observed using LDA (p<0.05).There was also a positive trend observed with the development of microvasculature in the fat graft with LDA. Using microCT, we observed a significant increase in fat graft volume retention with the desferal treated group compared to the saline treated group, and this was paralleled by improved histologic staining of skin and fat grafts (p<0.05).
Conclusion:
Our results show increased microvasculature and increased fat graft volume retention with desferal treatment. Desferal treatment may also promote beneficial effects in dermal thickness and in quality scoring of the fat grafts, thus leading to a potential clinical application in radiation damaged soft tissue.