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Published in: Aesthetic Plastic Surgery 3/2020

01-06-2020 | Smoking and Nicotine Detoxification | Original Article

Study of the Effect of Hyperbaric Oxygen Therapy on the Viability of Dorsal Cutaneous Flaps in Tobacco-Exposed Rats

Authors: C. P. Camargo, R. Z. Pfann, M. S. Kubrusly, M. F. R. Silva, E. T. Guimarães, M. S. Leite, P. H. N. Saldiva, R. Gemperli

Published in: Aesthetic Plastic Surgery | Issue 3/2020

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Abstract

Background

Smoking causes a threefold increase in the risk of surgical complications in flaps. Hyperbaric oxygen therapy (HBOT) increases the viability of chronic wounds. However, there are few studies concerning the effects of HBOT on surgical flaps in patients who smoke. This study aimed to analyze the effect of HBOT on the viability of cutaneous flaps in tobacco-exposed rats.

Methods

Twenty Wistar rats were exposed to tobacco smoke for two months. Following this period, all animals underwent a dorsal cutaneous flap (3 × 10 cm) surgery and were divided into two groups: control (n = 10) and HBOT (n = 10). HBOT was performed in seven daily sessions (2 ATA, 90 min). After seven days, the animals were euthanized. The outcomes were total area, viable area, viable area/total area rate, analysis of dermal appendages and angiogenesis (hematoxylin–eosin), and gene expression analysis of iNOS and VEGF-a biomarkers.

Results

The HBOT group showed an increase in viable area compared with the control group (84% versus 47%, p = 0.009, respectively). The HBOT group also showed an increase in appendage units (1.69 ± 0.54 versus 1.87 ± 0.58, p = 0.04) and angiogenesis density (1.29 ± 0.45 versus 1.82 ± 0.64, p < 0.001) compared to the control group. There was a difference between the control and HBOT groups in iNOS levels (0.926 ± 1.4 versus 0.04 ± 0.1 p = 0.002, respectively). However, this study did not show a difference between the groups concerning the gene expression of VEGF-a.

Conclusion

The use of hyperbaric oxygen therapy increased the viability of cutaneous flaps in tobacco-exposed rats and decreased iNOS mRNA levels; however, it did not change VEGF-a levels.
Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literature
11.
go back to reference Khandelwal S, Wall J, Kaide C, Katz G (2008) Case report: successful use of hyperbaric oxygen therapy for a complete scalp degloving injury. Undersea Hyperb Med 35(6):441–445PubMed Khandelwal S, Wall J, Kaide C, Katz G (2008) Case report: successful use of hyperbaric oxygen therapy for a complete scalp degloving injury. Undersea Hyperb Med 35(6):441–445PubMed
13.
go back to reference Otto GH, Buyukcakir C, Fife CE (2000) Effects of smoking on cost and duration of hyperbaric oxygen therapy for diabetic patients with non-healing wounds. Undersea Hyperb Med 27(2):83–89PubMed Otto GH, Buyukcakir C, Fife CE (2000) Effects of smoking on cost and duration of hyperbaric oxygen therapy for diabetic patients with non-healing wounds. Undersea Hyperb Med 27(2):83–89PubMed
16.
go back to reference Weber R, Silver A, Williams SJ, Stephenson L, Usera PC, Zhang F, Tian H, Yang W, Wang WZ, Fang XH, Zamboni WA, Baynosa R (2018) Random flap survival with hyperbaric oxygen: daily versus twice-daily treatments. Undersea Hyperb Med 45(2):157–164CrossRef Weber R, Silver A, Williams SJ, Stephenson L, Usera PC, Zhang F, Tian H, Yang W, Wang WZ, Fang XH, Zamboni WA, Baynosa R (2018) Random flap survival with hyperbaric oxygen: daily versus twice-daily treatments. Undersea Hyperb Med 45(2):157–164CrossRef
17.
go back to reference Ağir H, Mersa B, Aktaş S, Olgaç V (2003) Siçan karin deri flebi modelinde, iskemi-reperfüzyon hasarindan hemen sonra ve iki saat sonra uygulanan hiperbarik oksijen tedavisinin histolojik etkileri [Histologic effects of hyperbaric oxygen therapy administered immediately after or two hours after ischemia-reperfusion injury: a rat abdominal skin flap model]. Kulak burun bogaz ihtisas dergisi KBB J Ear Nose Throat 10(1):18–24 Ağir H, Mersa B, Aktaş S, Olgaç V (2003) Siçan karin deri flebi modelinde, iskemi-reperfüzyon hasarindan hemen sonra ve iki saat sonra uygulanan hiperbarik oksijen tedavisinin histolojik etkileri [Histologic effects of hyperbaric oxygen therapy administered immediately after or two hours after ischemia-reperfusion injury: a rat abdominal skin flap model]. Kulak burun bogaz ihtisas dergisi KBB J Ear Nose Throat 10(1):18–24
Metadata
Title
Study of the Effect of Hyperbaric Oxygen Therapy on the Viability of Dorsal Cutaneous Flaps in Tobacco-Exposed Rats
Authors
C. P. Camargo
R. Z. Pfann
M. S. Kubrusly
M. F. R. Silva
E. T. Guimarães
M. S. Leite
P. H. N. Saldiva
R. Gemperli
Publication date
01-06-2020
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 3/2020
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-020-01677-3

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