Enhancement of Auricular Composite Graft Survival With Hyperbaric Oxygen Therapy

Renner, Gregory J.; McClane, Stacie D.; Early, Elizabeth; Bell, Patricia L.; Shaw, Bharat

doi:10.1001/archfaci.4.2.102

Cited by 21 publications

(12 citation statements)

References 18 publications

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“…21 Other studies of rabbit auricular composite chondrocutaneous grafts have shown an overall survival benefit following HBO therapy. 22,23 Zhang et al, focused more specifically on the survival area of rat composite skin grafts. They found that HBO administered at 2.0 ATA daily for 5 days increased graft survival area by 82% compared to 26.5% in nontreated controls.…”

Section: Animal Studiesmentioning

confidence: 99%

Hyperbaric Oxygen Therapy for the Compromised Graft or Flap

Francis

Baynosa

2017

Advances in Wound Care

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Tissue grafts and flaps are used to reconstruct wounds from trauma, chronic disease, tumor extirpation, burns, and infection. Despite careful surgical planning and execution, reconstructive failure can occur due to poor wound beds, radiation, random flap necrosis, vascular insufficiency, or ischemia-reperfusion (IR). Traumatic avulsions and amputated composite tissues-compromised tissue-may fail from crush injury and excessively large sizes. While never intended, these complications result in tissue loss, additional surgery, accrued costs, and negative psychosocial patient effects. Hyperbaric oxygen (HBO) has demonstrated utility in the salvage of compromised grafts/flaps. It can increase the likelihood and effective size of composite graft survival, improve skin graft outcomes, and enhance flap survival. Mechanisms underlying these beneficial effects include increased oxygenation, improved fibroblast function, neovascularization, and amelioration of IR injury. Common strategies for the compromised graft or flap include local wound care, surgical debridement, and repeated reconstruction. These modalities are associated with added costs, time, need for reoperation, morbidity, and psychosocial effects. Preservation of the amputated/avulsed tissues minimizes morbidity and maximizes the reconstructive outcome by salvaging the compromised tissue and obviating additional surgery. HBO is often overlooked as a potential tool that can limit these issues. Animal studies demonstrate a benefit of HBO in the treatment of compromised tissues. Clinical studies support these findings, but are limited to case reports and series. Further research is needed to provide multicenter prospective clinical studies and cost analyses comparing HBO to other adjunctive therapies in the treatment of compromised grafts/flaps.

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Section: Animal Studiesmentioning

confidence: 99%

Hyperbaric Oxygen Therapy for the Compromised Graft or Flap

Francis

Baynosa

2017

Advances in Wound Care

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“…HBO therapy in rabbit auricular composite grafts has been shown to improve graft survival. 11,12 HBO therapy promotes angiogenesis and oxygen transport to tissues. 13 Although the consequences of HBO therapy on cartilage graft survival was investigated previously, the histopathologic alterations encountered in auricular cartilage grafts associated with HBO therapy were not investigated.…”

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confidence: 99%

The Changes in Histopathology and Mass in Hyperbaric Oxygen–Treated Auricular Cartilage Grafts in a Rabbit Model

Bilici¹,

Yiğit

Dönmez³

et al. 2015

Facial plast Surg

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The aim of the study is to investigate the histopathologic and cartilage mass changes in hyperbaric oxygen (HBO)-treated auricular cartilage grafts either crushed or fascia wrapped in a rabbit model. This is a prospective, controlled experimental study. Sixteen rabbits were randomly allocated into control (n = 8) and treatment groups (n = 8). Each group was further grouped as crushed cartilage (n = 4) and fascia wrapped crushed cartilage (n = 4). The eight rabbits in the treatment group had HBO once daily for 10 days as total of 10 sessions. The mass of cartilage, cartilage edge layout, structural layout, staining disorders of the chondroid matrix, necrosis, calcification besides bone metaplasia, chronic inflammation in the surrounding tissues, fibrosis, and increased vascularity were evaluated in the hematoxylin and eosin (H&E)-stained sections. Fibrosis in the surrounding tissue and cartilage matrix was evaluated with Masson's trichrome stain. The toluidine blue staining was used to evaluate loss of metachromasia in matrix. The prevalence of glial fibrillary acidic protein (GFAP) staining in chondrocytes was also evaluated. Although the remaining amount of cartilage mass after implantation does not show a significant difference between the control and the study group (p = 0.322, p <0.05).The difference between control and study group in terms of positive staining with GFAP was statistically significant (p = 0.01, p <0.05). Necrosis and loss of matrix metachromasia were significantly low in the study group compared with control group (p = 0.001, p = 0.006, p <0.05). HBO therapy did not have significant effect on the mass of rabbit auricular cartilage graft. HBO therapy significantly reduced loss of metachromasia, necrosis, and GFAP staining in the auricular cartilage grafts of the animal model.

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“…HBO improved the area of survival of reattached auricular composite grafts in New Zealand rabbits [15,16]. In their animal study on tracheal reconstruction with auricular cartilage grafts and HBO as an adjuvant, Gungor et al [14] found less inflammation, fibrosis, and necrosis, and earlier neovascularisation.…”

Section: Discussionmentioning

confidence: 99%

Effect of hyperbaric oxygen on survival of composite grafts in rats

Fodor

Ramon

Meilik

et al. 2006

Scandinavian Journal of Plastic and Reconstructive Surgery and

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Most treatment with hyperbaric oxygen (HBO) in plastic surgery is for wounds, burns, crush injuries, and infections. We aimed to find out if HBO increases the survival of composite grafts in rats. Twenty Sprague-Dawley rats were randomly assigned to two equal groups (treatment and control). A template 30 x 30 mm was placed on the skin and a composite graft taken from the upper back was harvested and then resutured to the fascia in situ. The treated group was placed in a hyperbaric chamber set at 202 kPa and 100% oxygen for 90 minutes daily for two weeks. Control animals were given no treatment. After death the mean surviving internal surface area of the graft was 372.5 (117.9) mm2 in the control group and 561.3 (85.7) mm2 in the experimental group (p=0.001). Treatment with HBO improved the surviving area of composite grafts in rats, and the beneficial effect was prominent only on the inner surface of the graft.

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Enhancement of Auricular Composite Graft Survival With Hyperbaric Oxygen Therapy

Cited by 21 publications

References 18 publications

Hyperbaric Oxygen Therapy for the Compromised Graft or Flap

Hyperbaric Oxygen Therapy for the Compromised Graft or Flap

The Changes in Histopathology and Mass in Hyperbaric Oxygen–Treated Auricular Cartilage Grafts in a Rabbit Model

Effect of hyperbaric oxygen on survival of composite grafts in rats

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