Action of hyperbaric oxygenation in the rat skin flap

Rech, Fabrício Valandro; Fagundes, Anna Luiza Negrini; Simões, Ricardo Santos; Florencio‐Silva, Rinaldo; Sasso, Gisela Rodrigues da Silva; Taha, Murched Omar; Fagundes, Djalma José

doi:10.1590/s0102-865020150040000001

Cited by 4 publications

(4 citation statements)

References 17 publications

(19 reference statements)

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“…Histological findings related to rats of the control group in the present study revealed the same results of Ayyildiz et al 11 , Choi et al 19 , and Rech et al 20 who showed that the main pathological changes in the skin flap are epidermal exfoliation, widespread neutrophil leukocyte infiltration, increased granulation tissue, increased inflammation, necrosis, and fibroblastic reaction ( Supplementary Fig. 3A).…”

Section: Discussionsupporting

confidence: 90%

The Effects of Sildenafil and/or Nitroglycerin on Random-pattern Skin Flaps After Nicotine Application in Rats

Ellabban

Fattah

Kader

et al. 2020

Sci Rep

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Smoking aggravates skin necrosis as a complication of random-pattern flap ischaemia. Sildenafil and nitroglycerin (NTG) are vasodilator agents that may affect skin flap survival. Fifty rats were subjected to a dorsal random-pattern flap operation and randomly divided into 5 groups. The control group received no treatment. The ischaemic group were administered local nicotine injections. The sildenafil group were administered oral sildenafil treatment in addition to the same intervention as the ischaemic group. The NTG group received topical NTG ointment application instead of sildenafil. The combined group were given both sildenafil and NTG treatments. After 7 days, all rats were sacrificed for flap assessment. Flap survival percentages at the 3 rd and 7 th days were significantly higher in the combined group than in the other study groups. Histologically, the ischaemic group exhibited dermal disorganization and inflammatory cell infiltration, which were improved in the 3 treated groups; however, the combined group presented the most relevant effect. The epidermal thickness showed a decrease in the ischaemic group (23.1 μm) that was significantly increased in the sildenafil (28.4 μm), NTG (28.8 μm) and combined (35.8 μm) groups. Immunohistochemically, the combined group exhibited a significant decrease in the apoptotic index and an increase in the proliferative index (2.3 and 56.9%, respectively) compared to those in the ischaemic (63.2 and 3%), sildenafil (41.7 and 28.1%) and NTG (39.3 and 30.4%) groups. Transmission electron microscopy (TEM) showed that the combined group displayed improvement in most of the ischaemic changes. Our analyses suggest that the combined use of sildenafil and NTG is more efficacious than using only one of these treatments for skin flap survival.Random skin flaps are widely used options for the reconstruction of large acquired or congenital skin defects 1 . Survival of these flaps is highly reliant on oxygen delivery to their tissues 2 . The main challenge is that the distal parts of the flap suffer from a reduced blood supply, which can trigger skin necrosis 3 . This reduction in the blood supply is mainly caused by anatomical or haemodynamic factors 4 . During vascular regeneration, ischaemia/reperfusion injury occurs, promoting oxidative stress and apoptosis 3 . Additionally, other factors, such as inadequate angiogenesis and inflammatory reactions, play roles in the pathogenesis of flap necrosis 5 .Skin flap ischaemic necrosis and increased incidence of infection can be aggravated by nicotine, which endangers the results of plastic skin reconstruction 6 . Smoking increases the risk of skin flap complications, which has been observed in clinical and experimental studies in both rats and hamsters 7 . Smokers have a higher risk of developing skin flap necrosis, namely, 13 times higher than that of non-smokers, which can result in flap loss or secondary contractures that negatively affect the aesthetic outcomes 6,8 . The potential mechanisms of this increased risk in smokers are highly...

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Section: Discussionsupporting

confidence: 90%

The Effects of Sildenafil and/or Nitroglycerin on Random-pattern Skin Flaps After Nicotine Application in Rats

Ellabban

Fattah

Kader

et al. 2020

Sci Rep

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“…Random skin flaps are frequently used to repair large areas of tissue loss. The technique is easy to perform and has low morbidity 25 . Nevertheless, even performed under the planning and execution of appropriate techniques, it has limitations and can result in variable degrees of failure 3 , 26 , 27 .…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study, an increase in the viability of the random flap was noticed attributed to the use of HBO for seven days after the operation. This positive effect was probably due to the maintenance of tissue oxygen pressure in poorly perfused and ischemic tissue areas, until the blood flow in the flap increases due to the response of the tissue to angiogenesis 1 , 25 . It should be mentioned that angiogenesis is modulated by growth factors that are located in endothelial cells and extracellular matrix 30 , 31 .…”

Section: Discussionmentioning

confidence: 99%

Effect of hyperbaric oxygenation on random rat skin flaps vascularization

et al. 2021

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“…Cellular oxygenation is carried out by transporting the oxygen (that is fixed to haemoglobin), from inspired air to the tissues and cells, through the circulatory system. Disruption or interruption of oxygen transport induces hypoxia through changes in haemoglobin, capillary network, or blood flow [8][9][10]. Oxygen has a very small molecule, which allows its increased diffusibility in tissues, in comparison to any other substance [11].…”

Section: Introductionmentioning

confidence: 99%

Clinical Assessment of the Hyperbaric Oxygen Therapy Efficacy in Mild to Moderate Periodontal Affections: A Simple Randomised Trial

et al. 2022

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Background and objectives: Gum disease represents the condition due to the dental plaque and dental calculus deposition on the surfaces of the teeth, followed by ulterior destruction of the periodontal tissues through the host reaction to the pathogenic microorganisms. The aim of study was to present aspects regarding the efficacy of hyperbaric oxygen therapy (HBOT) as an adjuvant therapy for the treatment of periodontal disease, started from the already certified benefits of HBOT in the general medicine specialties. Materials and methods: The participant patients in this study (71) required and benefited from specific periodontal disease treatments. All patients included in the trial benefited from the conventional therapy of full-mouth scaling and root planing (SRP) within 24 h. HBOT was performed on the patients of the first group (31), in 20 sessions, of one hour. The patients of the control group (40) did not benefit from HBO therapy. Results: At the end of study, the included patients in HBOT group presented significantly better values of oral health index (OHI-S), sulcus bleeding index (SBI), dental mobility (DM), and periodontal pocket depth (PD) than the patients of the control group. Conclusions: HBOT had beneficial effects on the oral and general health of all patients, because in addition to the positive results in periodontal therapy, some individual symptoms of the patients diminished or disappeared upon completion of this adjuvant therapy.

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Action of hyperbaric oxygenation in the rat skin flap

Cited by 4 publications

References 17 publications

The Effects of Sildenafil and/or Nitroglycerin on Random-pattern Skin Flaps After Nicotine Application in Rats

The Effects of Sildenafil and/or Nitroglycerin on Random-pattern Skin Flaps After Nicotine Application in Rats

Effect of hyperbaric oxygenation on random rat skin flaps vascularization

Clinical Assessment of the Hyperbaric Oxygen Therapy Efficacy in Mild to Moderate Periodontal Affections: A Simple Randomised Trial

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