The use of hypoxic preconditioning to prepare autodermografter for patients with compromised microcirculation

Objective: to study the impact of the concentration of cytokine HIF-1α in the donor area on the processes of reparative regeneration in free autodermografting by split-thickness skin graft for patients with disorders of the microvasculature and to improve results of autodermografting by local stimulation of HIF-1α to prepare skin graft to hypoxia conditions.

Materials and methods. The hypothesis of the influence of the local circulatory hypoxia on the concentration of HIF-1α was checked in the experiment with 18 white outbred male rats weighing 250–300 g. The microcirculation level was controlled by laser doppler flowmetry method. The indications to appraise the correctness of the hypothesis were analytical data of Enzyme Multiplied Immunoassay. This method of treatment was used in the clinic, where 18 patients with diabetic foot infections syndrome needed dermatoplastic surgery, and compared with the results of treatment of 22 patients with free autodermografting performed by traditional way.

Results. It is identified the significant difference in concentration of cytokine HIF-1α in the donor skin area in preparation it for hypoxia conditions by proposed method. The experimental data are confirmed in the clinic. After the free autodermografting based on developed technique in the main group the viability of grafter was preserved on Me (Q1; Q3) 84 (78; 93) % of its area. In the control group graft acceptance is registered on Me (Q1; Q3) 72 (65; 79) % of grafter area (p = 0.012).

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