A critical laboratory evaluation of transcutaneous PO2 monitoring and tissue pH monitoring in lower abdominal island flaps based on the superficial inferior epigastric vessels in rabbits revealed that transcutaneous PO2 values correlate poorly with tissue survival under circumstances of decreased arterial inflow. The inability of the transcutaneous PO2 monitor to accurately predict viability of the flaps in this study is attributed to physiologic changes in the microcirculation and not to instrument error. Tissue pH was, in all instances, a reliable index of the perfusion status of the flaps.
In vitro incubation of human scar in our laboratory with 99% DMSO demonstrated, by electron microscopy, the disruption of the collagen fibers. This may prove to be a useful preparatory step for selective enzymatic assault upon exuberant or undesirable scar tissue in the clinical setting. Further study of this concept is planned.
The results of this study indicated that there were no statistically significant differences between the effectiveness of 1% silver sulfadiazine in DMSO and 1% silver sulfadiazine in a hydrophilic base (Silvadene), when these formulations were used as antimicrobials applied topically to thermal burn wounds. The antimicrobial efficacy of silver sulfadiazine was not destroyed by mixing this agent with DMSO, since the recovery of Pseudomonas aeruginosa was significantly lower in all animals treated with silver sulfadiazine, whatever the formulation, when compared to animals not treated with silver sulfadiazine. Further studies with higher concentrations of silver sulfadiazine in DMSO may be useful. Although the concept of DMSO as a medicinal "carrier" is not novel, with further investigation, it may prove to be germane in the treatment of eschar-covered thermal burns.
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