Hyperbaric oxygenotherapy as a possible means of preventing ischemic changes in skin grafts used for soft tissue...

The Center of Hyperbaric Oxygenotherapy was established in September 2001 and started to provide hyperbaric treatment services for patients suffering from chronic, non-healing soft tissue defects in close cooperation with the Department of Plastic, Reconstructive and Aesthetic surgery, the Septic Department of the Traumatology Clinic and Vascular Surgery Department at the University Hospital of L. Pasteur, and the Medical Faculty of the University of P. J. Safárik. We usually deal with elderly patients suffering from various accompanying diseases such as diabetes mellitus, atherosclerosis, microangiopathy, blood clotting disturbances, nutritional deficits, etc. Hyperbaric oxygenotherapy can be of a great use in enhancing the survival of the skin grafts used for soft tissue defect closure. It can lower the percentage of graft failures by about 50% by enhancing the fibroblast proliferation and collagen synthesis supporting the required amount of oxygen in tissues (2). Hyperbaric oxygenotherapy is a form of treatment using increased levels of physically dissolved oxygen in blood plasma. This form of transported oxygen, compared with oxygen chemically bounded to hemoglobin, is able to enter tissues with minimal or almost no blood flow. A skin graft is a typical tissue with reduced nutritional and oxygen support, and in patients with a concomitant disease it can be very vulnerable. Ischemia and infection very often cause graft failure and recurrent operations (3). The patient is repeatedly invited for hospitalization and multiple operations, which enormously increases economical expenses and lowers the patient's trust in hospital staff. Adding hyperbaric oxygenotherapy into the treatment algorithm of indicated patients may be of considerable benefit to them and also to the whole society.