A free skin graft, the type of graft most commonly ap-plied to wounds of horses, can be either full thickness or partial thickness. A full-thickness graft is not as readily accepted as a partial-thickness graft, and if accepted, its upper layers are more likely to slough because a full-thickness graft requires more nourishment and has fewer exposed blood vessels available for imbibition of plasma and for inosculation.1–3 For these reasons, full-thickness skin grafting in humans is usually reserved for fresh, uncontaminated wounds.1
Treating patients with cutaneous wounds by use of HBOT increases the partial pressure of oxygen at the wound,4,5 which in turn enhances microbial killing by leukocytes, replication of fibroblasts, formation of collagen, and neovascularization of ischemic tissue.5 Treatment of human wounds with hyperbaric oxygen improves acceptance of partial-thickness and fullthickness skin grafts when the grafted wound is compromised by infection or its vascularity is inadequate to support the graft.6–9 A full-thickness graft applied to a granulating wound on a horse could be considered compromised because full-thickness grafts often require more nourishment than can be supplied by a granulating recipient wound.1–3
Infection is reported to be the most common cause of graft failure in horses,10 but chronic inflammation, inherently present during second intention healing of wounds on the distal portion of limbs of horses, may be at least as important because it reduces the quality of the granulation bed and results in the production of a moderate amount of purulent exudate, both of which negatively influence acceptance of grafts.11,12 Therefore, grafts applied to wounds of horses may be at greater risk of failure than are grafts applied to wounds of other species.
The purpose of the study reported here was to determine the effects of HBOT on full-thickness skin grafts applied to fresh and granulating wounds of horses. We wished to test the hypothesis that if oxygenation of a full-thickness graft could be enhanced after grafting by use of HBOT, survival of the graft, including its superficial layers, would be improved.
Hyperbaric oxygen therapy
SAS, version 9.1, SAS Institute Inc, Cary, NC.
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Wilmink JM, Stolk PWT, van Weeren PR, et al. Differences in second-intention wound healing between horses and ponies: macroscopic aspects. Equine Vet J 1999;31:53–60.
Wilmink JM, van Weeren PR, Stolk PWT, et al. Differences in second-intention wound healing between horses and ponies: histological aspects. Equine Vet J 1999;31:61–67.
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