ABSTRACT
OBJECTIVES: This study was designed to determine if a) hyperbaric oxygen increases the tissue oxygenation of free flaps and b) verification of this effect is possible by using a recently validated and innovative method for two-dimensional pO2 measurement (Luminescence lifetime imaging = LLI). METHODS: Six patients with a free parascapular flap transplanted to the lower limb received hyperbaric oxygen (HBOT) therapy. The HBOT regimen consisted of treatment over 90 minutes with 100% O2 (FiO2 1.0) at 240 kPa (Marx-Schema). The transcutaneous oxygen partial pressure (ptcO2) was measured over the entire flap with the use of luminescence lifetime imaging (LLI) before and 30, 60, 120 minutes after treatment. The LLI is based on the oxygen dependent quenching of phosphorescence of the indicator dye platinum (II)-octaethyl-porphyrin implemented in a polystyrene sensor foil. RESULTS: In all six free flaps we could find a significant increase of tissue oxygen over the entire flap in form of increased R-values as well as subsequently calculated absolute ptcO2 values over a period of 120 min after hyperbaric therapy. The ptcO2 values increased significantly from 42.59 ± 1.11 Torr before to 81.14 ± 5.95 Torr after hyperbaric treatment (p < 0.001). Even after 2 hours the ptcO2 values were significantly higher (83.45 ± 13.80 Torr) compared with values prior to HBOT (p < 0.006). CONCLUSIONS: The findings of this study demonstrated an increase of oxygen supply over the entire flap after hyperbaric oxygen therapy.
Subject(s)
Free Tissue Flaps , Hyperbaric Oxygenation/methods , Leg Injuries/surgery , Leg Injuries/therapy , Wounds and Injuries/therapy , Adult , Aged , Female , Humans , Male , Middle Aged , Optical Devices , Oxygen/administration & dosage , Oxygen/metabolism , Partial Pressure , Prospective Studies , Wounds and Injuries/surgery , Young AdultABSTRACT
We report about a case of a pregnant women in the 23rd gestation week who sustained an isolated acetabular fracture in a car accident. The fracture was treated surgically by open reduction and internal fixation 6 days after trauma. The outcome for the mother and the baby was excellent; both could be followed up for 1.5 years. The baby did not suffer from any disease related to the diagnostic or surgical procedures. We conclude from this case and from reviewing the literature that the operative fixation of an acetabular fracture during pregnancy is the appropriate treatment with minimal risk for the unborn child and best outcome for the mother.
