Skin-sparing mastectomy flap ischemia salvage using urgent hyperbaric chamber oxygen therapy: a case report

Since its introduction in 1991, skin-sparing mastectomy has emerged as an acceptable surgical technique in the management of breast cancer patients, providing optimal oncological safety and efficacy with favorable aesthetic results. Rates of native skin flap ischemia and necrosis after skin-sparing mastectomy are 2%-30% and result in a decreased aesthetic outcome and delay of necessary adjuvant treatment. Hyperbaric oxygen therapy has been advocated for the management of various compromised flaps, and when instituted immediately postoperatively, may prevent progression of ischemia into necrosis. We report the case of a 41-year-old female who developed skin flap ischemia after undergoing skin-sparing mastectomy and was immediately treated with hyperbaric oxygen. The patient received a total of five hyperbaric oxygen therapy sessions, achieving full resolution of the ischemia without any complications. Further research is essential to determine the role of hyperbaric oxygen therapy in managing skin flap ischemia post skin-sparing mastectomy. Until such studies exist, hyperbaric oxygen therapy may be considered a preferred option in the management of native skin flap ischemia after skin-sparing mastectomy.