Effects of hyperbaric oxygen therapy on fibrovascular ingrowth in porous polyethylene blocks implanted under burn scar tissue: An experimental study

Effects of hyperbaric oxygen (HBO) therapy on biointegration of porous polyethylene (PP) implanted beneath dorsal burn scar and normal skin were experimentally examined in Sprague-Dawley rats. In Group One (n = 20), daily HBO treatments were given after the implantation of PP material under dorsal burn scar, whereas, in Group Two (n = 20) no treatment was given following the same surgical procedure. In Group Three (n = 20), PP was placed under dorsal normal skin and subsequently HBO therapy protocol was applied while Group Four (n = 20) stayed without HBO treatment after the implantation. One, 2, 3 and 4 weeks after the implantations, sections were respectively taken from five rats from each group. Biointegration process and effects of HBO therapy were evaluated microscopically and the ratio of fibrovascular ingrowth (FVI) was determined for each rat. The results showed significantly superior FVI in Group One compared to Group Two and again FVI into PP under normal skin treated with HBO revealed better results against Group Four (p < 0.05). Well-vascularized capsule formation and tissue integration was delayed both in Group Two and in Group Three in the first 3 weeks. In conclusion, HBO therapy enhances biointegration of PP in hypoxic burn scar areas via improving collagen synthesis and neovascularization; otherwise, it apparently delays tissue ingrowth into porous structure implanted in normal healthy tissues.