The effect of hyperbaric oxygen therapy on the survival of random pattern skin flaps in nicotine-treated rats

Previous studies have shown that nicotine increases the risk of necrosis in skin flaps. We investigated the effect of hyperbaric oxygen (HBO2) treatment on the survival of random skin flaps in nicotine-treated rats. Thirty-two SpragueeDawley rats were divided into four groups with eight rats in each group. Group 1 (n=8) was the control, group 2 (n=8) received HBO2 treatment without being exposed to nicotine, group 3 (n=8) received nicotine and group 4 (n=8) received HBO2 treatment with exposure to nicotine. The rats in the nicotine-treated groups were prepared by treating them with nicotine for 28 days. At the end of the 28th day, standard McFarlane-type random skin flaps were lifted from the backs of all the rats. In groups 2 and 4, HBO2 treatment started at the 30th min following the surgery and continued once a day for 7 days. The flap survival rates and histopathological evaluation results related to neovascularisation and granulation tissue formation were significantly better in the HBO2-treated groups (groups 2 and 4) than in the groups that did not receive HBO2 treatment (groups 1 and 3) (p < 0.05). The flap survival rates, neovascularisation and granulation tissue formation were highest in group 2 and lowest in group 3 (p <= 0.001). No significant difference was observed between group 4, which received HBO2 treatment with nicotine exposure, and the control group (group 1) (p > 0.05). In conclusion, our study demonstrates that HBO2 treatment has a positive effect on flap survival in nicotine-treated rats. (C) 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.