Efeitos de heparina e oxigenação hiperbárica na redução de necrose em modelo animal para desluvamentos

Abstract

INTRODUCTION: Degloving injuries are an specific category of wound, when occurs devascularization of tissue and ischemic injury, with high levels of morbidity and mortality. OBJECTIVES: To evaluate the efficacy of hyperbaric oxygen therapy and use of topic and intralesional heparin in a experimental model of degloving injuries. METHODS: There was used adult male Wistar rats, submitted to degloving injury of right lower limb, from the base of the thigh to the ankle articulation, under general anesthesia with ketamine plus xylazine. Animals was divided into four groups: Control; Heparin – topic spray heparin daily over the injury site; Hyperbaric Oxigenation – daily 30 minutes sessions in chamber with 100% O 2 and 2 ATA pressure and Positive Control – 45 mg/kg intraperitoneal alopurinol, single dose. All the animals received prophylactic antibiotic with benzathine penicillin 40.000 UI/kg and analgesia with dipyrone added to the water (2 mg/mL). On the seventh postoperative day, animals were submitted to euthanasia and skin flaps was taken out and total area and necrotic area was measured and necrotic percentage was calculated. RESULTS: Necrotic percentage average in control group was 56.03%; in positive control group was 51.36%, p=0.2; in heparin group 42.10% p≤0.05; and in hyperbaric oxygen group 31.58% p≤0.01. DISCUSSION: There was significant reduction of necrosis percentage in animals treated with hyperbaric oxygenation and also in the animals of heparin group. The model used on this study must be understood as also a model of doubt or debil vascularization skin flaps suggesting possibility of new studies of this therapeutic modalities in other situations of Plastic Surgery and other kind of diseases involving tissue ischemia, as heart attack, coronarian ischemia, stroke and limbs vascular insufficiency. CONCLUSION: Both heparin topic administration and hyperbaric oxygenation shows efficacy in reduction of necrotic area percentage in this model.