Application of normobaric hyperoxygenation to an ischemic flap and a composite skin graft.
Application of normobaric hyperoxygenation to an ischemic flap and a composite skin graft.
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DOI：
10.1097/gox.0000000000000029
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发表时间：
2014-05
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影响因子：
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通讯作者：
Yoshimura K
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文献类型：
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作者：
Araki J;Kato H;Doi K;Kuno S;Kinoshita K;Mineda K;Kanayama K;Yoshimura K
补充数字内容可在正文中找到。高压氧有多种用途，但由于其肺部毒性，其临床应用受到限制。我们评价了常压高氧(NBO)对带血管和非带血管组织移植的治疗价值。在吸氧量分别为20%、60%和100%的情况下，对小鼠不同器官的组织氧分压(PtO2)进行了测定。在小鼠背部制作矩形皮瓣(1 × 4 cm)或复合皮瓣(2 × 2 cm)，术后3d置于20%或60%氧气中。在器官培养皮肤样本中也检测了细胞存活情况。PtO2随组织/器官的不同而不同，但随所有组织/器官吸氧量的增加而增加。虽然100%氧气的NBO是有毒的，但60%O2的NBO即使长期连续使用也是安全的。NBO不能显著提高矩形皮瓣的成活率。另一方面，复合皮片移植面积显著增加(20%时为52 ± 10，60%时为68 ± 5.1)，收缩明显减小(20%时为42 ± 8.0，60%时为27 ± 5.7)。复合皮肤样本的器官培养显示，在较低的氧气浓度下，细胞显著死亡，支持体内数据。通过周围组织的血浆扩散，复合移植物一直保持到血运重建，其中PtO2被NBO改善。NBO可能是一种有效的辅助治疗方法，可在非血管化组织移植后方便地进行。
Supplemental Digital Content is available in the text. Hyperbaric oxygenation has been used for various purposes, but its clinical application is limited due to its pulmonary toxicity. We evaluated the therapeutic value of normobaric hyperoxygenation (NBO) for vascularized and nonvascularized tissue transplantation. Tissue oxygen partial pressure (PtO2) was measured for various organs in mice under inspiratory oxygen of 20%, 60%, or 100%. A rectangular skin flap (1 × 4 cm) or a composite skin graft (2 × 2 cm) was made on the back of mice, which were housed under 20% or 60% oxygen for the first 3 days after surgery. Cell survival was also examined in organ culture skin samples. PtO2 varied among tissues/organs, but increased depending on inspiratory oxygen concentration in all tissues/organs. Although NBO with 100% O2 was toxic, NBO with 60% O2 was safe even when used continuously for a long period. NBO did not significantly improve survival of the rectangular skin flap. On the other hand, in the composite skin graft model, the engraftment area increased significantly (52 ± 10 at 20% vs 68 ± 5.1 at 60%) and contraction decreased significantly (42 ± 8.0 at 20% vs 27 ± 5.7 at 60%). Organ culture of a composite skin sample showed significant cell death under lower oxygen concentrations, supporting the data in vivo. The composite graft was maintained until revascularization by plasmatic diffusion from surrounding tissues, in which PtO2 was improved by NBO. NBO may be an effective adjunct therapy that can be performed readily after nonvascularized tissue grafting.