Coverage of Free Flap Vascular Pedicles by Basic Fibroblast Growth Factor-impregnated Collagen-Gelatin Sponge Without Skin Graft

抄録

In a 49-year-old man, a free flap was grafted to cover a tissue defect after surgery for frontal osteomyelitis. On the following day, due to venous thrombosis, the patient underwent removal of the venous thrombus and vascular re-anastomosis with a vein graft. A basic fibroblast growth factor-impregnated collagen-gelatin sponge (bFGF-CGS) was used to close the wound without compression of the vascular pedicles. Postoperatively, the free flap survived without recurrence of venous thrombosis, and the bFGF-CGS graft site was completely epithelialized without additional skin grafting. The grafted bFGF-CGS slowly released basic fibroblast growth factor, which in turn continuously promoted the proliferation of fibroblasts, angiogenesis, and epithelialization. Furthermore, bFGF-CGS is more durable because of its double-layered structure, and compression fixation is not required after grafting. The bFGF-CGS appears to be useful for the coverage of vascular anastomotic sites and vascular pedicles after free flap grafting, which requires strict management. Therefore, bFGF-CGS is an excellent material for regenerative medicine. We report its usefulness with regard to our first case, in which it was used to cover free flap vascular pedicles.