PHARMACOLOGICAL ENHANCEMENT OF CUTANEOUS FLAP SURVIVAL WITH TOPICAL DIMETHYL-SULFOXIDE AND HYDROGEN-PEROXIDE

The present study was designed to investigate, in a rabbit model, the value of topical application of a solution of hydrogen peroxide (H2O2) 8% + dimethyl sulphoxide (DMSO) 50% in order to reduce ischaemic fail ure in random skin flaps. Two parallel, cephalad-based para-midline ra ndom cutaneous flap (10 cm x 2.5 cm) were elevated and resutured in pl ace on the dorsum of 40 New Zealand rabbits. The 80 flaps thus obtaine d were then randomly divided into one control group and three experime ntal groups of 20 flaps each. Flaps from the control group (Group A) w ere topically treated with saline, while flaps from experimental Group B were treated with H2O2 8%, flaps from experimental Group C with DMS O 50%, and flaps from experimental Group D with a solution of 50% DMSO + 8% H2O2. Each solution was topically applied to the flaps, 20 ml th ree times a day for 7 days, starting in the immediate postoperative pe riod. Transcutaneous oxygen tension (PtcO(2)) measurements were carrie d out in all flaps 72 h after flap elevation. The percentage of surviv ing skin area of each flap was determined by planimetry 7 days after f lap elevation. The mean surviving area of the Group A (control) flaps was 71%, the mean surviving area of the Group B (H2O2-treated) flaps w as 72%, the mean surviving area of the Group C (DMSO-treated) flaps wa s 76%, and that of the Group D (DMSO+H2O2-treated flaps was 92%. While no statistically significant differences were found between the survi val rates of both the flaps treated with H2O2 or DMSO alone and that o f the control group, the mean surviving rate of the DMSO+H2O2 treated flaps (+20%) was statistically higher than that of the control flaps. Similarly, a statistically significant difference has been found betwe en the mean PtcO(2) values of the DMSO+H2O2 flaps and those of the oth er three groups of flaps.