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Effects of hyperbaric oxygen on full-thickness meshed sheet skin grafts applied to fresh and granulating wounds in horses

Troy E. C. HolderDepartment of Large Animal Clinical Sciences, and Pathobiology (Donnell), College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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Jim SchumacherDepartment of Large Animal Clinical Sciences, and Pathobiology (Donnell), College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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Robert L. DonnellDepartment of Pathobiology, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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Barton W. RohrbachDepartment of Comparative Medicine, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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H. Steve A. AdairDepartment of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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Abstract

Objective—To determine the effects of hyperbaric oxygen therapy (HBOT) on full-thickness skin grafts applied to fresh and granulating wounds of horses.

Animals—6 horses.

Procedures—On day 0, two 4-cm-diameter circular sections of full-thickness skin were removed from each of 2 randomly selected limbs of each horse, and two 4-cm-diameter circular skin grafts were harvested from the pectoral region. A skin graft was applied to 1 randomly selected wound on each limb, leaving the 2 nongrafted wounds to heal by second intention. On day 7, 2 grafts were harvested from the pectoral region and applied to the granulating wounds, and wounds grafted on day 0 were biopsied. On day 14, 1 wound was created on each of the 2 unwounded limbs, and the wounds that were grafted on day 7 were biopsied. All 4 ungrafted wounds (ie, 2 fresh wounds and 2 wounds with 1-week-old granulation beds) were grafted. The horses then received HBOT for 1 hour daily at 23 PSI for 7 days. On day 21, the grafts applied on day 14 were biopsied.

Results—Histologic examination of biopsy specimens revealed that grafts treated with HBOT developed less granulation tissue, edema, and neovascularization, but more inflammation. The superficial portion of the graft was also less viable than the superficial portion of those not treated with HBOT.

Conclusions and Clinical Relevance—The use of HBOT after full-thickness skin grafting of uncompromised fresh and granulating wounds of horses is not indicated.

Abstract

Objective—To determine the effects of hyperbaric oxygen therapy (HBOT) on full-thickness skin grafts applied to fresh and granulating wounds of horses.

Animals—6 horses.

Procedures—On day 0, two 4-cm-diameter circular sections of full-thickness skin were removed from each of 2 randomly selected limbs of each horse, and two 4-cm-diameter circular skin grafts were harvested from the pectoral region. A skin graft was applied to 1 randomly selected wound on each limb, leaving the 2 nongrafted wounds to heal by second intention. On day 7, 2 grafts were harvested from the pectoral region and applied to the granulating wounds, and wounds grafted on day 0 were biopsied. On day 14, 1 wound was created on each of the 2 unwounded limbs, and the wounds that were grafted on day 7 were biopsied. All 4 ungrafted wounds (ie, 2 fresh wounds and 2 wounds with 1-week-old granulation beds) were grafted. The horses then received HBOT for 1 hour daily at 23 PSI for 7 days. On day 21, the grafts applied on day 14 were biopsied.

Results—Histologic examination of biopsy specimens revealed that grafts treated with HBOT developed less granulation tissue, edema, and neovascularization, but more inflammation. The superficial portion of the graft was also less viable than the superficial portion of those not treated with HBOT.

Conclusions and Clinical Relevance—The use of HBOT after full-thickness skin grafting of uncompromised fresh and granulating wounds of horses is not indicated.

Contributor Notes

Supported by the Center of Excellence, College of Veterinary Medicine, University of Tennessee.

The authors thank Equineox Technologies for providing the equine hyperbaric chamber.

Address correspondence to Dr. Holder.