Hyperbaric oxygenation and antioxidant vitamin combination reduces ischemia-reperfusion injury in a rat epigastric island skin-flap model.

Reperfusion injury, caused by free oxygen radicals, is a chain of events that occurs in tissues exposed to a constant period of ischemia. The antioxidant vitamins E and C (VEC) and hyperbaric oxygenation (HBO) have beneficial effects in treating ischemic tissues following skin flap operations. In our study, we aimed to compare the effects of VEC and/or HBO in ischemia-reperfusion injury induced by free oxygen radicals in an experimental rat epigastric island skin-flap model. Eight hours of ischemia was provided by clamping the inferior epigastric pedicle following the flap elevation. The flap survey was determined to be 28.6% in controls, 59.2% in HBO group, 66.3% in VEC + HBO group, and 82% in VEC group (p < 0.05). We conclude that although HBO and/or VEC increased the flap viability significantly by reducing ischemia-reperfusion injury, the most promising results were obtained in the antioxidant vitamins group.