Bone marrow cell implantation improves flap viability after ischemia-reperfusion injury

This study attempted to clarify the effects of therapeutic neovascularization by bone marrow cells for salvaging flaps after ischemia-reperfusion injury. Bone marrow mononuclear cell layer (endothelial progenitor cell-enriched fraction) was isolated from the mouse femur and tibia. Symmetrical double flaps were elevated in mice. Each flap topically received phosphate buffered saline (PBS) or bone marrow cells in PBS. Flaps were subjected to 6-hour ischemia and subsequent reperfusion. On the seventh postoperative day, the flap survival area was measured (n = 27). The mean survival area of bone marrow cells-transplanted flaps was 66.3 +/- 18.0%, whereas control flaps showed a survival area of 49.7 +/- 22.2%. The difference was highly significant (P = 0.000209). Histologic examination revealed the average vascular density of bone marrow cells-transplanted flaps had significantly increased. The present study proved bone marrow cells acted with significant efficacy in promoting the survival of ischemia-reperfusion-mediated damaged tissue.