title: Does hyperbaric oxygen administration before or after irradiation decrease side effects of irradiation on implant sites?
abstract: BACKGROUND
  One of the main limitations of implant-based breast reconstruction is the high rate of complications such as capsular contracture and poor aesthetic outcome, due to adjuvant radiotherapy. Hyperbaric oxygen treatment (HBOT) has been used to assist wound healing in the prevention and treatment of the side effects of irradiation. We aimed to investigate this effect of HBOT on the capsule reaction and skin, applied before and after irradiation, following the placement of an implant under the dorsal skin of the rat.
  
  
  METHODS
  Fifteen Wistar rats were randomly divided into 3 groups. A 18-mL smooth testicular implant was introduced into a subcutaneous pocket located on the dorsum of each rat. A single dose of 17-Gy irradiation was given to the implanted area of each rat at the third week. HBOT which lasted 3 weeks was administered to group I before irradiation, group II after irradiation. The control group did not receive HBOT. All of the rats were killed at the ninth week (6 weeks after irradiation). The dorsal skin with the capsule overlying the implant were excised for histopathological processing. The thickness of the capsule reaction of each group was evaluated statistically.
  
  
  RESULTS
  Our histopathological examination revealed changes due to radiation in the control group. Many of these findings were found to be more subtle in group I and nearly absent in the group II. There was not any statistical difference between the thickness of the capsule reactions of the control group and group I, or group I and group II, but the capsular thickness of the control group was statistically higher than group II.
  
  
  CONCLUSIONS
  It can be predicted that the use of HBOT following irradiation is an effective tool to reduce the capsule reaction of the implanted area and the tissue damage seen in radiodermatitis.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Maltepe University, Istanbul, Turkey. burcaktumerdem@yahoo.com
authors.forename: Burcak
authors.initials: B
authors.lastname: Tumerdem-Ulug
authors.forename: Ismail
authors.initials: I
authors.lastname: Kuran
authors.forename: Burcu C
authors.initials: BC
authors.lastname: Ozden
authors.forename: Ozgur
authors.initials: O
authors.lastname: Mete
authors.forename: Gonul
authors.initials: G
authors.lastname: Kemikler
authors.forename: Samil
authors.initials: S
authors.lastname: Aktas
authors.forename: Burcu
authors.initials: B
authors.lastname: Calik
mesh_terms: D000818:Animals; D019928:Breast Implantation / Q000379:methods*; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006931:Hyperbaric Oxygenation; D008297:Male; D011832:Radiation Injuries / Q000517:prevention & control*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D012867:Skin / Q000473:pathology / Q000528:radiation effects*; D014945:Wound Healing / Q000528:radiation effects*