Effect of hyperbaric oxygen on pedicle flaps with compromised circulation

Ülkür, Ersi̇n; Yüksel, Fuat; Açıkel, Cengiz Han; Çeli̇köz, Bahatti̇n

doi:10.1002/micr.22004

Cited by 34 publications

(17 citation statements)

References 29 publications

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“…Our findings are in agreement with those reported in previous studies [11,[19][20][21][22]. This could be attributed to that; HBO was found to increase the tensile strength in skin wounds and stimulate angiogenesis histologically [23,24]. The angiogenic properties induced by HBO are derived from the increase in oxygen tension that may persist for several hours after HBOT [13,25].…”

Section: Discussionsupporting

confidence: 92%

Hyperbaric Oxygen: Silver Bullet for Diabetic Foot Ulcers

Sharari¹,

Saleh²

2013

J Def Manag

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Background: Hyperbaric Oxygen Therapy (HBOT) involves the administration of pure oxygen under high pressure conditions. HBOT is used as an adjuvant therapy for a variety of conditions; including chronic wounds, infections, stroke, tissue transplantation, anemia, cancer management, skin flaps & grafts, CO poisoning, air or gas embolism, decompression thickness, necrotizing fasciitis, crush injury, compartment syndrome, gas gangrene and autism.Objective: This prospective study was designed to evaluate the efficacy of HBOT as adjuvant treatment for diabetic foot ulcers in comparison to the conventional treatment. Patients and methods:This study comprised 82 diabetic patients, aged 38 to 72 years. Patients were randomized into two groups: Group A assigned to receive HBOT in combination with conventional wound care & group B received conventional wound care only for the treatment of diabetic foot ulcers. Outcomes were measured every week for 1 st two months during the treatment period and then at three-month intervals for one year. Ulcers were graded using Wagner classification system. Both groups were compared as regards healing time, need of amputation, quality of life. Results:The demographic characteristics of the 82 patients were 28 women (34%) and 54 men (65.9%), age range from 32 to 72 years. The median ulcer duration for both groups was 7.2 months, and the median ulcer area was 3.5 cm2. There was non-significant difference between both groups as regard demographic characteristics. Complete healing of the index ulcer was significantly faster in hyperbaric group 50% in comparison to 29% in group B. 2 major amputation were performed in HBOT group as compared to 3 cases in group B; all of them were Wagner grade IV. Five minor amputations were performed in each group during the 1st year of follow up. 63% of group A were satisfied as regard the management of their ulcers in comparison to 41% in group B.

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Section: Discussionsupporting

confidence: 92%

Hyperbaric Oxygen: Silver Bullet for Diabetic Foot Ulcers

Sharari¹,

Saleh²

2013

J Def Manag

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“…In skin wounds, HBO was found to increase the breaking strength and stimulate angiogenesis histologically. [23] The angiogenic properties induced by HBO are derived from the increase in oxygen tension that may persist for several hours after HBO. [68] Comparison of G-S and G-NAC groups revealed that repeated “on-off” exposures produce a favourable environment in random flaps.…”

Section: Discussionmentioning

confidence: 99%

Effects of hyperbaric oxygen and N-acetylcysteine in survival of random pattern skin flaps in rats

Rocha

Fagundes

Pires

et al. 2012

Indian J Plast Surg

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Objective:Our aim is to investigate the role of HBO (hyperbaric oxygen), NAC (N-acetylcysteine), and HBO plus NAC on the necrosis area of random rat's skin flaps of a modified McFarlane flap design.Materials and Methods:Thirty-two male Wistar rats were randomly divided into four groups: G-S (sham: n = 8), G-NAC (NAC: n = 8), G-HBO (HBO: n = 8), and G-HN (HBO plus NAC: n = 8). A rectangular skin flap (2 × 8 cm2) was dissected from the muscular dorsal layer, preserving the cranial pedicle. Polyethylene film was placed over the muscular layer and an interrupted 3.0 nylon suture was employed to fix the flap into the original place. On the eighth day, full-thickness biopsy samples (2 × 1 cm2) were collected from the proximal, middle, and cranial areas of the skin flap, and in a site away from the flap labelled as the control area.Results:The measurements of necrotic areas in the groups were 18.3% in G-S, 24.3% in G-NAC, 12.6% in G-HBO, and 14.9% in G-HN. Significant difference was observed between the groups G-HBO and G-HN as well as G-NAC.Conclusion:HBO is associated with reduced area of necrosis of skin flap. The G-NAC group was associated with poor results when examined in isolation. The association between HBO and NAC did not produce favourable results with respect to the use of HBO alone. These findings suggest that the diffusion of oxygen through the interstitial space was the determining factor of more favourable results of HBO.

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“…In skin wounds, HBO is related to the improvement of breaking strength of lesions and angiogenesis stimulation [19][20] . It is believed that the HBO angiogenesis properties are due to increased oxygen tension that may persist for several hours after HBO 14,21 .…”

Section: Regionmentioning

confidence: 99%

“…It is believed that the HBO angiogenesis properties are due to increased oxygen tension that may persist for several hours after HBO 14,21 . However, some authors suggest that the high rate of oxygen increases the production of free radicals, which could increase necrosis 15 , whereas others suggest that treatment with HBO causes peripheral arteriolar vasoconstriction 19 .…”

Section: Regionmentioning

confidence: 99%

Action of hyperbaric oxygenation in the rat skin flap

et al. 2015

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PURPOSE:To evaluate the morphology, necrotic area and collagen content in skin flaps of rats subjected to hyperbaric oxygenation (HBO). METHODS:Forty adult rats were divided into four groups: GEC -epilated; GE/HBO -epilated subjected to HBO; GER -epilated submitted to skin flap (2 cm in width /8 cm length in the dorsal area) and GER/HBO -epilated, subjected to skin flap and HBO. HBO (2.4 ATA) was performed for two hours during seven consecutive days. In the eighth day, the rats were anesthetized and the skin flaps were removed and separated into three portions, relative to pedicle fixation. The material fixed in 10% formalin was processed for paraffin embedding; sections were stained by H.E and subjected to picrosirius-red method. The slides examined under light microscopy for evaluation of the collagen content in polarized light microscope and ImageLab ® software (Bio-Rad). RESULTS:The data showed larger area of necrosis and lower levels of collagen in the three regions of the GER group, whereas in the GER/HBO group the collagen content was similar to the GEC and GE/HBO groups. CONCLUSION:Hyperbaric oxygenation reduced the area of necrosis and preserved the morphology and collagen content in skin flaps of rats.

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Effect of hyperbaric oxygen on pedicle flaps with compromised circulation

Cited by 34 publications

References 29 publications

Hyperbaric Oxygen: Silver Bullet for Diabetic Foot Ulcers

Hyperbaric Oxygen: Silver Bullet for Diabetic Foot Ulcers

Effects of hyperbaric oxygen and N-acetylcysteine in survival of random pattern skin flaps in rats

Action of hyperbaric oxygenation in the rat skin flap

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