| Tissue expansion has been widely used in plastic surgery as a good method to provide additional soft tissue. However, traditional tissue expansion has to take a very long time about 6 to 12 weeks to gain enough tissue. This disadvantage does not exist in rapid tissue expansion, which is a special tissue expansion costs a much shorter therapeutic period. But a shorter process often brings a higher retraction rate of the expanded skin. So we designed this experiment to investigate whether hyperbaric oxygen therapy has a positive effect to reduce the retraction rate of rapid expanded tissue or not, and to find a new approach to enlarge candidates of rapid tissue expansion.A total of 24 New Zealand male rabbits were divided randomly into four groups:①g roup A were treated by HBO therapy after expander inflation everyday②group B were not treated by HBO therapy after expander inflation③g roup C were the traditional ones④group D were not inflated as the negative control group. The blood flow and skin temperature of the expanded areas on group A and B were examined before and after operation, inflation and HBO therapy. When the expansion were completed, a quadrate expanded flap of each rabbit was harvested and at the same time the thickness and tension in vivo, instant retraction rate, weight of the flaps were measured. Then we took specimens to perform histological examination stained with HE and ultrastructural observation under transmission electron microscope.Experimental results are as following:(1) The temperature of expanded skin of group A and B both decreased about 0.6℃after expander inflation at the former seven days, however at the latter three days the temperature changes of group A were very slight, while group B decreased the same degree as before;(2) The blood flow of group A was 93.32±11.93pu on average before operation, and group B was 96.35±14.31pu.At the first two days after operation there was no significant difference between the two groups, but after that, the blood flow of group A became much higher than that of group B, and at the last day the blood flow of group A before inflation increased to 130.63±16.68pu, while group B decreased to 35.05±4.89pu;(3)When the expansion was finished, the average thickness of expanded skin of group A in vivo was 1.3233±0.04457(mm), much thicker than 0.9850±0.08689 (mm) of group B, but thinner than 1.4700±0.05404(mm) of group C and 1.6133±0.10596(mm) of group D;(4)The flap weight of the four group were 2.6467±0.13866(g), 1.7150±0.14977(g), 3.4367±0.41731(g) and 2.8100±0.51498(g) on average respectively. Obviously the weight of flaps from group A is heavier than that of group B;(5)The instant retraction rate of group A is 29.2817±4.35780%, which is slightly more than group C(22.0220±1.85763%), but much less than 46.3100± 3.41094% of group B;(6)The largest tension in vivo belong to flaps of group B, of which the average tension is 33.9167±4.78390(g)and 26.5000±2.45031(g)in the transverse and longitudinal axis respectively. Group A is 15.3000±1.47648(g)in the transverse axis and 12.9833±0.73598(g)in the longitudinal axis.(7) Under optical microscopy, the epidermal layer of the expanded skin of group A is much thicker than the other three groups. As well, its cell lays increased. The ultrastructural study showed that the specimen of group A had more active fibroblasts with bigger nucleolus and richer cytoplasm.From the results, we reached the following conclusions:The application of hyperbaric oxygen therapy in the expansion period of rapid expansion can effectively promote the blood flow of expanded skin and increased its biological growth, thus reduce the instant retraction and tension in vivo of expanded skin in an accelerated period. The results indicated the value of this technique to enlarge candidates,reduce complications, and improve the effect of rapid tissue expansion.
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