Sıçan karın deri flebi modelinde, iskemi-reperfüzyon hasarından hemen sonra ve iki saat sonra uygulanan hiperbarik oksijen tedavisinin histolojik etkileri
Amaç: Sıçan karın deri flebi modelinde iskemi-reperfüzyonhasarından İRH hemen sonra ve iki saat sonra uygulananhiperbarik oksijen tedavisinin sıçan akciğer dokusu ve fleplerdeki histolojik etkileri arafltırıldı.Çalıflma Pl a n ı : Sprague-Dawley türü sıçandan 10’ar adetlik üçgrup oluflturuldu. Sıçanların sol taraf karın bölgesindeki süperfisyal inferior epigastrik pediküllü deri flepleri kaldırıldı. On saatlik global iskeminin ardından reperfüzyona bırakılan fleplerdeİRH oluflturuldu. Birinci grup kontrol grubu olurken, HBO tedavisine ikinci grupta reperfüzyonun hemen ardından, üçüncügrupta ise iki saat sonra bafllandı. Tedavi protokolü, 2.5 ATA’ d a10 dakikalık iki hava molası ile 90 dakika olarak, ilk gün dört seans, sonraki iki gün üçer seans, son üç gün ikifler seans olmaküzere toplam altı gün 16 seans uygulandı. Altıncı gün fleplerinyaflam oranları hesaplandı. Sıçan flep ve akciğerlerinden alınan örnekler histolojik olarak değerlendirildi. Bu l g u l a r : Kontrol grubunda ortalama %25.87 oranında flepcanlılığı gözlendi. Bu oran, reperfüzyonun ardından hemen tedaviye bafllandığında %90.93’e, iki saat sonra bafllandığında%84.34’e çıktı. Kontrol grubu ve tedavi grupları arasında istatistiksel olarak anlamlı fark bulundu p0.05 .Histolojik kesitlerin incelenmesi, yoğun HBO’nun sıçan akciğerlerinde değiflikliğe neden olmadığını, İRH’nin fleplerde yol açtığıolumsuz değifliklikleri azaltığını, dokuları koruduğunu gösterdi.Sonu ç : Kullandığımız yoğun HBO tedavi protokolü, İRH’li sıçankarın deri flebinde, doku yaflamını destekleyerek canlılığı anlamlı derecede artırmakta ve hasarın boyutlarını azaltmaktadır
Anahtar Kelimeler:
Graft canlılığı, hiperbarik oksijenasyon, iskemi/fizyopatoloji/metabolizma, nekroz/önleme ve kontrol, oksijen/farmakoloji, sıçan, reperfüzyon hasarı/fizyopatoloji/etyoloji/önleme ve kontrol, cerrahiflepler, zaman faktörü, transplantasyon, otolog
Histologic effects of hyperbaric oxygen therapy administered immediately after or two hours after ischemia-reperfusion injury: a rat abdominal skin flap model
Objectives: İn a rat abdominal skin flap model, we investi- gated the histologic effects of hyperbaric oxygen HBO ther apy on the skin flaps and the lung tissue immediately after and two hours after ischemia-reperfusion injury İRİ .Study Design: Thirty Sprague-Davvley rats vvere assigned to three groups equal in number. The first group vvas left as Con trols. The left inferior abdominal skin flap based on the superficial inferior epigastric vessels vvas elevated. Follovving 10 hours of global ischemia, HBO therapy vvas started immediately after and tvvo hours after reperfusion in groups 2 and 3, respectively.Our protocol included a course of 16 HBO treatments in six days at 2.5 ATA for 90 minutes, vvith four sessions on the first day, three sessions on the second and third days, and tvvo sessions on the fourth, fifth, and sixth days. On the sixth day, survival rates for ali flaps vvere calculated. Histologic examination vvas made on specimens taken from rat flaps and lungs.Results: The mean flap survival vvas 25.87% in the control group.İt significantly increased to 90.93% and 84.34% in HBO-treated rats in groups 2 and 3, respectively p<0.001 . There vvas no sig- nificant difference betvveen HBO-treated groups p>0.05 .Histologically, neither minör nor majör changes vvere observed in HBO-treated rat lung tissues. Similarly, compared to the Controls, thrombosis in flap microvasculature, intimal damage, edema, neu- trophil infiltration, and necrosis vvere considerably less and neo- vascularization vvas significantly higher in HBO-treated flap tissues.Conclusion: Intense HBO treatment protocol used in this study significantly increases flap survival in rataxial skin flap model and reduces deleterious effects of İRİ.
Keywords:
Graft survival, hyperbaric oxygenation, ischemia/physiopathology/metabolism, necrosis/prevention & control, oxygen/pharmacology, rats, reperfusion injury/physiopathology/etiology/prevention & control, surgical flaps, time factors, transplantation, autologous,
___
- Kerrigan CL, Stotland MA. Ischemia re p e r f u s i o n injury: a review. Microsurgery 1993;14:165-75.
- May JW Jr, Chait LA, O'Brien BM, Hurley JV. The no- reflow phenomenon in experimental free flaps. Plast Reconstr Surg 1978;61:256-67.
- Manson PN, Anthenelli RM, Im MJ, Bulkley GB, Hoopes JE. The role of oxygen-free radicals in ischemic tissue injury in island skin flaps. Ann Surg 1983;198: 87-90.
- Pang CY, Forrest CR, Mounsey R. Pharmacologic inter- vention in ischemia-induced reperfusion injury in the skeletal muscle. Microsurgery 1993;14:176-82.
- Champion WM, McSherry CK, Goulian D Jr. Effect of hyperbaric oxygen on the survival of pedicled skin flaps. J Surg Res 1967;7:583-6.
- Gruber RP, Brinkley FB, Amato JJ, Mendelson JA. Hyperbaric oxygen and pedicle flaps, skin grafts, and burns. Plast Reconstr Surg 1970;45:24-30.
- Nemiroff PM, Merwin GE, Brant T, Cassisi NJ. Effects of hyperbaric oxygen and irradiation on experimental skin flaps in rats. Otolaryngol Head Neck Surg 1985; 93:485-91.
- Perrins DJ. The effect of hyperbaric oxygen on ischemic skin flaps. In: Grabb WC, Myers MB, editors. Skin flaps. 2nd ed. Boston: Little Brown; 1975. p. 53-63.
- McFarlane RM, Wermuth RE. The use of hyperbaric oxygen to prevent necrosis in experimental pedicle flaps and composite skin grafts. Plast Reconstr Surg 1966;37:422-30.
- Wald HI, Georgiade NG, Angelillo J, Saltzman HA. Effect of intensive hyperbaric oxygen therapy on the survival of experimental skin flaps in rats. Surg Forum 1968;19:497-9.
- Jurell G, Kaijser L. The influence of varying pressure and duration of treatment with hyperbaric oxygen on the survival of skin flaps. An experimental study. Scand J Plast Reconstr Surg 1973;7:25-8.
- Manson PN, Im MJ, Myers RA, Hoopes JE. Impro v e d capillaries by hyperbaric oxygen in skin flaps. Surg F o rum 1980;31:564-6.
- Quirinia A, Viidik A. The effect of hyperbaric oxygen on diff e rent phases of healing of ischaemic flap wounds and incisional wounds in skin. Br J Plast Surg 1995;48:583-9.
- Angel MF, Im MJ, Chung HK, Vander Kolk CA, Manson PN. Effects of combined cold and hyperbaric oxygen storage on free flap survival. Microsurgery 1994;15:648-51.
- Kindwall EP, Gottlieb LJ, Larson DL. Hyperbaric oxy- gen therapy in plastic surgery: a review article. Plast Reconstr Surg 1991;88:898-908.
- Kaelin CM, Im MJ, Myers RA, Manson PN, Hoopes JE. The effects of hyperbaric oxygen on free flaps in rats. Arch Surg 1990;125:607-9.
- Zamboni WA, Roth AC, Russell RC, Nemiroff PM, Casas L, Smoot EC. The effect of acute hyperbaric oxy- gen therapy on axial pattern skin flap survival when a d m i n i s t e red during and after total ischemia. J Reconstr Microsurg 1989;5:343-7.
- Tan CM, Im MJ, Myers RA, Hoopes JE. Effects of hyperbaric oxygen and hyperbaric air on the survival of island skin flaps. Plast Reconstr Surg 1984;73:27-30.
- I z q u i e rdo R, Swartz WM, Sutker KB, Boydell CL, Almand J. Attenuation of reperfusion-induced lipoper- oxidation by systemic use of oxygen radical scavengers after pedicle occlusion. Ann Plast Surg 1992;28:175-9.
- Zamboni WA, Roth AC, Russell RC, Smoot EC. The effect of hyperbaric oxygen on reperfusion of ischemic axial skin flaps: a laser Doppler analysis. Ann Plast Surg 1992;28:339-41.
- Kernahan DA, Zingg W, Kay CW. The effect of the hyperbaric oxygen on the survival of experimental skin flaps. Plast Reconstr Surg 1965;36:19-25.
- Shupak A, Gozal D, Ariel A, Melamed Y, Katz A. Hyperbaric oxygenation in acute peripheral posttrau- matic ischemia. J Hyperbaric Med 1987;1:7-14.
- Thom SR. Functional inhibition of leukocyte B2 inte- grins by hyperbaric oxygen in carbon monoxide-medi- ated brain injury in rats. Toxicol Appl Pharmacol 1993; 123:248-56.
- Larson JL, Stephenson LL, Zamboni WA. Effect of hyperbaric oxygen on neutrophil CD18 expression. Plast Reconstr Surg 2000;105:1375-81.
- Tai YJ, Birely BC, Im MJ, Hoopes JE, Manson PN. The use of hyperbaric oxygen for preservation of free flaps. Ann Plast Surg 1992;28:284-7.
- Eric P, Kindwall MD (editors). Hyperbaric medicine prac- tice. 1st ed. Flagstaff: Best Publishing Company; 1995.
- ISSN: 2602-4837
- Yayın Aralığı: Yılda 4 Sayı
- Başlangıç: 1991
- Yayıncı: İstanbul Üniversitesi