Effect of Hyperbaric Oxygen and Growth Factors on Rabbit Ear Ischemic Ulcers

doi:10.1001/archsurg.1994.01420340057010

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Vol. 129 No. 10, October 1994

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Effect of Hyperbaric Oxygen and Growth Factors on Rabbit Ear Ischemic Ulcers

Lily L. Zhao, MD; John D. Davidson, MD; Sang Chin Wee, MD; Sanford I. Roth, MD; Thomas A. Mustoe, MD

Arch Surg. 1994;129(10):1043-1049.

Abstract

Objective
To test the influence of hyperbaric oxygen (HBO), platelet-derivedgrowth factor—BB (PDGF-BB), and transforming growth factor–β1(TGF-β1) on the deficit in wound healing produced by ischemiain a noncontractive dermal ulcer standardized model in the rabbitear.

Design and Interventions
Dermal ulcers were created in the ischemic ears of 42 anesthetizedyoung female New Zealand white rabbits. The controls were ulcerscreated in nonischemic ears of eight anesthetized young femaleNew Zealand white rabbits. Either PDGF-BB (5 µg), TGF-β1(1 µg), or buffer alone was applied to each wound, whichwas then covered. Some groups were treated with HBO on days0 through 4. Wounds were harvested on day 7 and were evaluatedhistologically.

Main Outcome Measures
The amount of epithelial regrowth and granulation tissue productionwere measured. The wounds were evaluated for glycosaminoglycanand collagen content. Angiogenesis was measured.

Results
Hyperbaric oxygen alone, in the ischemic model, increased theproduction of new granulation tissue by approximately 100% at7 days without significantly affecting new epithelial growth(P=.03). In contrast, PDGF-BB and TGF-β1 each increasedthe new granulation tissue volume by greater than 200% in 7days (P=.0001) and also had a statistically significant effecton new epithelial growth. However, the addition of growth factorsto HBO treatment produced a synergistic total reversal of thewound-healing deficit produced by ischemia (P=.0001).

Conclusions
Both PDGF-BB and TGF-β1 alone are more effective than HBOtreatment by itself in accelerating the impaired wound healingproduced by ischemia. However, the combination of HBO with eitherof the growth factors has a synergistic effect that totallyreverses the deficit produced by ischemia.

(Arch Surg. 1994;129:1043-1049)

Author Affiliations

From the Division of Plastic Surgery (Drs Zhao and Mustoe) and the Department of Pathology (Dr Roth), Northwestern University School of Medicine, Chicago, Ill, the Division of Hyperbaric Medicine, St Luke's Hospital, and the Department of Medicine, Washington University School of Medicine, St Louis, Mo (Dr Davidson), and the Department of Plastic Surgery, Catholic University Medical School, Seoul, Korea (Dr Wee).

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