The negative effect of hyperbaric oxygen therapy at the acute phase of electrochemical esophageal burn induced by button battery ingestion.
OBJECTIVE
Ingestion of button battery, if lodges in esophagus, causes mucosal destruction in esophagus and may damage surrounding tissues due to electrochemical reactions which may lead to esophagus perforation, tracheosefageal fistula and other serious problems. We designed an experimental study to test the effect of hyperbaric oxygen therapy on battery induced electrochemical tissue damage in the esophagus of a rabbit model and possible change with duration of contact time.


METHODS
Button batteries were inserted in esophagus of 40 rabbits which were divided into four groups. Groups 1 and 2 had 15 min of duration of contact time of battery in esophagus, while Groups 3 and 4 had 30 min. Groups 1 and 3 had hyperbaric oxygen therapy for 3 days; Groups 2 and 4 did not. At the end of 3rd day all animals were sacrified and samples were taken from the esophagus for determination of malondialdehyde levels and for histopathological examination to compare: mucosal destruction, muscular layer involvement, perforation and tracheal involvement between groups.


RESULTS
Malondialdehyde levels, mucosal destruction, muscular layer involvement, perforation and tracheal involvement were significantly higher in groups which had 30 min of contact time compared to groups which had 15 min. The same assessments were significantly higher in Group 1 (15 min of contact time with hyperbaric oxygen therapy) compared to Group 2 (15 min of contact time without hyperbaric oxygen therapy). However, the difference between Group 3 (30 min of contact time with hyperbaric oxygen therapy) and Group 4 (30 min of contact time, no hyperbaric oxygen therapy) was not significant.


CONCLUSIONS
Our study demonstrated that if contact time is 15 min HBO had an additive adverse effect to electrochemically burned esophagus by increasing free radicals and eventually tissue damage. However, if the contact time is 30 min its adverse effect is shielded by huge electrochemical destruction due to long contact time.
Aydin
Atakan
A
Department of Plastic and Reconstructive Surgery, Istanbul Medical Faculty, Turkey. atakanaydin@yahoo.com
Aktas
Samil
S
Hafiz
Gunter
G
Kabakas
Fatih
F
Erer
Metin
M
Bilgic
Bilge
B
D000208:Acute Disease; D000818:Animals; D002057:Burns, Chemical / Q000150:complications*; D002058:Burns, Electric / Q000150:complications*; D004935:Esophageal Diseases / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D005547:Foreign Bodies / Q000145:classification*; D006931:Hyperbaric Oxygenation / Q000379:methods*; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D009092:Mucous Membrane / Q000378:metabolism / Q000473:pathology; D011817:Rabbits; D011897:Random Allocation
D008315:Malondialdehyde