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September 1994

Effect of Free-Radical Scavengers and Hyperbaric Oxygen on Random-Pattern Skin Flaps

Arch Surg. 1994;129(9):982-988. doi:10.1001/archsurg.1994.01420330096017

Objective:  To determine whether treatment with the combination of hyperbaric oxygen and free-radical scavengers or inhibitors would result in increased skin-flap survival.

Design:  An animal model with male Sprague-Dawley rats was used. The flap was a cranial-based dorsal 3× 12-cm random-pattern skin flap that included the panniculus carnosus. Rats were randomly assigned to one of 10 treatment groups.

Interventions:  The radical scavengers superoxide dismutase, catalase, and α-tocopherol acetate and the inhibitor allopurinol were used to combat or scavenge radicals. Oxygen (100%) treatments were for 90 minutes at 2.5 atm absolute daily.

Main Outcome Measures:  At 7 days, the flaps were examined for survival by fluorescein injection. Lipid peroxidation as a measure of tissue damage was measured by thiobarbituric acid—malondialdehyde analysis.

Results:  The combination of treatments resulted in significantly increased flap survival compared with untreated controls (P<.05) except in the group treated with allopurinol and hyperbaric oxygen. Lipid peroxidation was inhibited by the superoxide dismutase plus catalase and the α-tocopherol treatments but not by treatment with allopurinol.

Conclusion:  Moderate doses of radical scavengers or antioxidants coupled with a conservative hyperoxic exposure regimen can result in the increased survival of random-pattern skin flaps.(Arch Surg. 1994;129:982-988)