The bloodless greater omentum for myocardial revascularization

Novel strategy for soft tissue augmentation based on transplantation of fragmented omentum and preadipocytes

Current therapeutic procedures for soft tissue augmentation still lack the ability to induce rapidly formation of adipose tissue and its long-term stability, which is determined by rapid revascularization. The omentum is highly vascularized with microvascular endothelial cells (ECs) and is composed mainly of adipocytes that produce an enormously high level of vascular endothelial growth factor (VEGF). The aim of this study was to determine the potential usefulness of fragmented omentum tissues, with or without cotransplantation with preadipocytes, in soft tissue augmentation. Fragmented omentum tissues (approximately 500 mg) with or without preadipocytes (approximately 2.3 x 10(6)) isolated from epididymal adipose tissues were transplanted under the dorsal skin of Wistar rats by percutaneous injection and the tissues were left under the skin for up to 12 weeks. Regardless of cotransplantation with preadipocytes, the general morphological features of the transplanted tissue were as follows. The transplanted tissues, the weight loss of which was limited to 30-40%, contained viable adipocytes and some pseudocysts surrounded by fibrotic septa with minor inflammatory cell infiltration. High levels of triacylglycerol content, capillary density, and VEGF production were observed in transplanted tissues 12 weeks postoperation. Cotransplantation with preadipocytes enhanced adipose tissue formation significantly. These observations strongly indicate that transplantation of fragmented omentum tissues or cotransplantation with preadipocytes may be a promising therapeutic procedure for soft tissue augmentation.

Treatment of recurrent cerebrospinal fluid rhinorrhea with a free vascularized omental flap: a case report

Cerebrospinal fluid fistulas after pericranial surgery are a major source of morbidity. A patient who underwent transsphenoidal sinus surgery for a recurrent pituitary adenoma was presented. The patient developed a chronic CSF leak despite standard management, including subarachnoid CSF drainage and transnasal endoscopic closure of the dura. Successful closure of the CSF fistula was obtained using a free omental flap to the sphenoid sinus. This case is the first reported use of a free microvascularized omental flap in an intracranial position for treating chronic CSF rhinorrhea. A description of the indications and the surgical technique for free omental closure of CSF fistulas was provided. The etiology, diagnosis, and management of CSF rhinorrhea are reviewed for the reconstructive surgeon.

Omentum and basic fibroblast growth factor in healing of chronic gastric ulcerations in rats

Omentum was shown to exhibit angiogenic activity, but its role in healing of chronic gastric ulcers is unknown. This study was designed to compare the effects of omentum and basic fibroblast growth factor (bFGF), a potent angiogenic factor, on healing of chronic gastric ulcers in rats. Several series of rats with gastric ulcers were used: series A with intact omentum (control), series B with omentum resected, and series C with omentum placed on the serosal side of the ulcer. Series A-C were divided into four groups treated with vehicle (I); indomethacin (II), an inhibitor of prostaglandin formation, difluoromethylornithine (DFMO) (III); an inhibitor of polyamine biosynthesis or bFGF (IV). Seven days after ulcer induction, the animals were anesthetized, the gastric blood flow (GBF) was determined by laser Doppler flowmetry (LDF), and the ulcer area was measured by planimetry. Biopsy samples of the ulcer margin were taken for determination of the number of capillaries and myofibroblasts in the granulation tissue. Attachment of omentum significantly accelerated ulcer healing, whereas omentectomy delayed this process. LDF revealed the decrease in the GBF at the ulcer margin to 45% and at the ulcer bed to 18% of the value recorded in the intact adjacent mucosa. Attachment of the omentum significantly increased the blood flow at the ulcer margin and increased the number of capillaries and myofibroblasts in the granulation tissue. Indomethacin (1 mg/kg/day) that inhibited mucosal PGE2 by about 85% delayed significantly ulcer healing without affecting the blood flow in the ulcer area.(ABSTRACT TRUNCATED AT 250 WORDS)