Vascular and epidermal effects of fibroblast growth factor on irradiated and nonirradiated skin flaps

Head and neck cancer surgeons are often faced with the challenge of managin g previously irradiated soft tissue that has poor vascularity and slower ep ithelialization. This study investigates the effect of supplemental basic f ibroblast growth factor (bFGF) on flap vascularity, tissue oxygenation, and epidermal regeneration in nonirradiated (n = 40) and irradiated porcine sk in flaps (n = 40). Supplemental bFGF increased vascularity in nonirradiated flaps by 80% (p = .005), with a trend to a higher tissue oxygen level by d ay 14. The irradiated bFGF-treated flaps did not show increased vascularity or higher tissue oxygen levels 2 weeks after surgery. However, in both irr adiated and nonirradiated groups, epidermal regeneration increased by great er than 70% with supplemental bFGF (p < .002). The results of this study su ggest that supplemental bFGF can increase tissue vascularity in nonirradiat ed tissues and epidermal regeneration in both nonirradiated and irradiated conditions.