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A Free Radical Scavenger Reduces Hematoma-Induced Flap Necrosis in Fischer Rats

Free radicals have been shown to play an important role in hematoma-induced flap necrosis. The present study investigated the effect of deferoxamine, a free radical scavenger and iron chelator, on flap necrosis. A 4×2 cm dorsal flap was raised in Fischer inbred rats, and 3 cc of blood from inbred donors was instilled beneath the flap. Saline-treated control animals (Group 1) were compared with two experimental groups. In Group 2, deferoxamine 150 mg/kg was administered 15 minutes before surgery and every 8 hours for 5 days. In Group 3, deferoxamine was given every 8 hours for 3 days before surgery and every 8 hours for 5 days postoperatively. Flap necrosis was assessed on postoperative day 5. Group 2 had significantly less necrosis, 18.6%, than the control group, 64.0% (p <0.001). Group 3, with 36.0% necrosis, also showed improvement (p <0.05). Group 2 and Group 3 were not significantly different. Deferoxamine, a safe and well-tolerated free radical scavenger, greatly enhanced flap survival, presumably by the neutralization of damaging free radical species and by Chelation of iron.