A dissolved oxygen dressing: A pilot study in an ischemic skin flap model

Objectives To determine if skin flap failure rates could be improved with the use of a dissolved oxygen wound dressing in a porcine model. Methods Full-thickness skin flaps (4x16cm) were raised on pigs. Flaps were randomly assigned after surgery to experimental treatment with a dissolved oxygen dressing (treatment group) or a hydrogel dressing (control group). Flaps were evaluated daily for 14 days. Skin flaps that failed any one of four key clinical outcomes were considered failures. Histological parameters (including skin and subcutaneous necrosis, inflammation, ischemia, fibrosis, and bacterial load) were compared by a blinded histopathologist. Results Sixteen full-thickness skin flaps were raised on four pigs. All animals survived surgery and all incisions were evaluable. Clinical flap failure was observed in six (75%) control-treated wounds and in two (25%) dissolved oxygen-treated wounds. Histological evaluation demonstrated no significant differences in the proximal 75% of the flaps. There were significant differences in a number of histological parameters in the distal 25% in favor of the dissolved oxygen dressing. Conclusions Flaps treated with a dissolved oxygen dressing had fewer clinical failures and improved histological profiles compared with control-treated flaps, suggesting that increasing local oxygen supply may improve the local wound healing environment.