Hydrogen-rich saline reduces tissue injury and improves skin flap survival on a rat hindlimb degloving injury model


Ergan Sahin A., KARASOY YEŞİLADA A., Yalcin O., Guler E. M., Erbek H., Karabıyık D.

Journal of Plastic, Reconstructive and Aesthetic Surgery, vol.74, no.9, pp.2095-2103, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 74 Issue: 9
  • Publication Date: 2021
  • Doi Number: 10.1016/j.bjps.2020.12.045
  • Journal Name: Journal of Plastic, Reconstructive and Aesthetic Surgery
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Page Numbers: pp.2095-2103
  • Keywords: Degloving injury, Flap, Hydrogen-rich saline, Ischemia, reperfusion injury
  • Istanbul Medipol University Affiliated: Yes

Abstract

Background: Degloving injuries represent a challenge in plastic surgery. The aim of this study is to acknowledge the protective effects of hydrogen-rich saline (HRS) solution on a rat hindlimb degloved skin flap. Methods: Twenty-one Sprague–Dawley rats were divided into three groups (control, saline and HRS). Degloving injury model was established, and flaps were sutured back following 5 min of ischemia. The control group did not receive any treatment. The saline group received intraperitoneal physiological saline (10 ml/kg) and the HRS group received intraperitoneal HRS solution (10 ml/kg) postoperatively and daily for 5 days after the operation. Skin samples were obtained for histological, immunohistochemical and biochemical evaluations. Results: Inflammation was lower in the HRS compared with saline (p = 0.02) and control (p = 0.004) groups. Edema was lower in the HRS compared with saline (p = 0.02) and control (p = 0.001) groups. Malondialdehyde (MDA) level was lower in the HRS than the control group (p = 0.01). Total antioxidant level was higher in the HRS compared with saline (p = 0.009) and control (p = 0.03) groups. Total oxidant level was lower in the HRS than the control group (p = 0.02). Oxidative stress index was lower in the HRS compared with saline (p = 0.001) and control (p = 0.0001) groups`. Vascular proliferation was higher in the HRS compared with the control group (p = 0.01). Conclusion: Repeated HRS injections after trauma increased the viability of skin flap in rat degloving injury model by decreasing local tissue injury, due to its antioxidant, anti-inflammatory and angiogenic effects.