Effect of HMGB1/NF-κB in hyperbaric oxygen treatment on decreasing injury caused by skin flap grafts in rats.

ABSTRACT

BACKGROUND: Skin flap grafting (SFG) is a common surgical operation, and hyperbaric oxygen treatment (HBOT) is an important strategy for restoring the grafted skin flap. Thus, we employed a rat skin flap grafting model treated with HBO, and expression levels of high mobility group protein 1 (HMGB1) and NF-kappaB (nuclear factor-kappaB) were characterized. MATERIALS AND METHODS: Forty rats were randomly assigned to 5 groups (1) sham-operation (SH), (2) ischemia followed by reperfusion 3 days after operation (IR3d), (3) ischemia followed by reperfusion 5 days after operation (IR5d), (4) ischemia followed by reperfusion and HBOT 3 days after operation (HBO3d), and (5) ischemia followed by reperfusion and HBOT 5 days after operation (HBO5d). Elevated pedicled skin flaps were designed (size, 9 cm × 6 cm), and feeding vessels were clamped. The microvascular clamp was removed 3 h later and flow was restored. In the HBO3d and HBO5d groups, rats received 1 h of hyperbaric oxygen (HBO) starting immediately after surgery for 3 days and 5 days, respectively. Upon completion of animal experiments, rats were euthanized by general anesthesia, and blood samples were taken for testing. The tissues were sectioned for western blotting and immunohistochemical staining. RESULTS: Expression of HMGB1 and NF-κB proteins in the HBO groups was lower than in the IR groups. CONCLUSIONS: The results suggest that HBOT can be used to reduce ischemia-reperfusion (IR) injury of skin flap grafts.