EFFECT OF DEFEROXAMINE AND HYPERBARIC-OXYGEN ON FREE, AUTOGENOUS, FULL-THICKNESS SKIN-GRAFTS IN DOGS

Free, autogenous, full-thickness skin grafts were applied to 10 dogs; 5 dogs were given an iron chelator, deferoxamine-10% hydroxyethyl pent afraction starch (DEF-HES; 50 mg/kg of body weight, IV), and 5 dogs we re given an equal volume of 10% hydroxyethyl pentafraction starch (HES ) in 0.9% saline solution (5 ml/kg, IV). All dogs (DEF-HES/HBO- and HE S/ HBO-treated) were exposed to 60 minutes of hyperbaric oxygen (HBO) at 2 atmospheres absolute pressure twice daily for 10 days, beginning the day of surgery. The percentage of viable graft on day 10 was lower in HES/HBO-treated dogs (mean +/- SD, 13.3 +/- 21.3%; median, 3.0%) t han in DEF-HES/HBO-treated dogs (64.7 +/- 39.2%; 88.3%; P = 0.095, Man n-Whitney two-tailed test). There was a positive correlation between p ercentage of viable graft (on day 10) and percentage of haired skin on the graft site (on day 28) for all dog; (r = 0.91) and for HES/HBO-tr eated dogs (r = 0.97). The DEF-HES/HBO-treated dogs had less consisten t correlation (r = 0.67). Perivascular aggregates of foamy cells were observed in the superficial and reticular portions of the dermis and i n the subcutaneous tissue on both surfaces of the panniculus muscle in the graft sites of DEF-HES/HBO-treated dogs. These cells were also ob served in the dermis, but not subcutaneous tissue of the control skin sections, and in some viscera of DEF-HES/HBO-treated dogs. Deferoxamin e appears to attenuate the detrimental effect of HBO and HES on surviv al of free skin grafts. However, clinical use of HBO is not recommende d as adjunct treatment for free skin grafts in dogs in the first 10 da ys after grafting. Administration of DEF-HES is not recommended becaus e it has failed to improve the survival of free skin grafts, and the c onsequence of the cellular response seen in this study is undetermined .