Stewart R J, Moore T, Bennett B, Easton M, Newton G W, Yamaguchi K T
University of California-San Francisco Valley Medical Education Program.
Arch Surg. 1994 Sep;129(9):982-7; discussion 987-8. doi: 10.1001/archsurg.1994.01420330096017.
To determine whether treatment with the combination of hyperbaric oxygen and free-radical scavengers or inhibitors would result in increased skin-flap survival.
An animal model with male Sprague-Dawley rats was used. The flap was a cranial-based dorsal 3 x 12-cm random-pattern skin flap that included the panniculus carnosus. Rats were randomly assigned to one of 10 treatment groups.
The radical scavengers superoxide dismutase, catalase, and alpha-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.
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.
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 alpha-tocopherol treatments but not by treatment with allopurinol.
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.
确定高压氧与自由基清除剂或抑制剂联合治疗是否会提高皮瓣存活率。
采用雄性Sprague-Dawley大鼠动物模型。皮瓣为基于颅骨的背部3×12厘米随意型皮瓣，包括腹直肌。大鼠被随机分配到10个治疗组之一。
使用自由基清除剂超氧化物歧化酶、过氧化氢酶和α-生育酚醋酸酯以及抑制剂别嘌呤醇来对抗或清除自由基。每天在绝对压力2.5个大气压下进行90分钟的100%氧气治疗。
在第7天，通过荧光素注射检查皮瓣存活情况。通过硫代巴比妥酸-丙二醛分析测量脂质过氧化作为组织损伤的指标。
与未治疗的对照组相比，联合治疗显著提高了皮瓣存活率（P < 0.05），但别嘌呤醇与高压氧治疗组除外。超氧化物歧化酶加过氧化氢酶和α-生育酚治疗可抑制脂质过氧化，但别嘌呤醇治疗则不能。
中等剂量的自由基清除剂或抗氧化剂与保守的高氧暴露方案相结合可提高随意型皮瓣的存活率。
