Hematoma-induced flap necrosis and free radical scavengers

Skin flap necrosis due to underlying hematoma can be devastating in reconstructive surgery. The production of free radicals in ischemic tissue and cellular damage caused by them have been well established. Deferoxamine, which is both an iron chelator and a free radical scavenger may have a dual benefit in the pharmacologic manipulation of necrosis in a flap jeopardized by hematoma. Past studies showing the importance of free radical scavengers in improving flap survival in hematoma-induced flap necrosis have used the rat model. The porcine model was used for this study because it is the animal model that most closely resembles human skin. A statistically significant benefit of deferoxamine in reducing necrosis of a skin flap induced by hematoma formation was found. Deferoxamine appears to be promising but requires further investigation before it can be optimally used in human applications.