Defining the Role of Hyperbaric Oxygen Therapy as an Adjunct to Reconstructive Surgery

The discipline of reconstructive surgery has been slow to accept the role of hyperbaric oxygen therapy (HBOT) as an adjunct to surgery, despite clinical and experimental data showing potential benefits. Obstacles prevent this acceptance; one of the most potent is surgeon bias. This article attempts to lessen this bias by reviewing the benefits of HBOT in conditions where there is uniform acceptance of its role, such as carbon monoxide poisoning and decompression illness. It demonstrates that these conditions have similar pathophysiologic derangements to conditions commonly encountered by the reconstructive/wound care surgeon, including crush injuries, compartment syndrome, compromised flaps, and thermal burns.