The effect of hyperbaric oxygen therapy on split-thickness skin graft uptake in posttraumatic wounds and donor site...

Trauma is among the leading causes of skin loss or degloving. Flaps and skin grafts are common surgical procedures to repair or replace the lost skin over open wounds, and split-thickness skin grafting (STSG) is the most common approach.

To assess the effect of hyperbaric oxygen therapy (HBOT) on STSG uptake and donor site healing.

This trial was conducted on patients with traumatic wounds who underwent STSG as per inclusion criteria. The patients were randomized into 2 groups. One group received standard care after skin grafting, and the other received HBOT in addition to standard care. Uptake of STSG was assessed on postoperative day (POD) 4 and POD 7, and donor site healing was assessed on POD 11 and POD 15.

A total of 64 patients aged 18 years to 60 years were included in the study. Mean (standard deviation [SD]) percentage graft uptake on POD 4 was 92.44% (5.98%) in the HBOT group and 88.12% (8.92%) in the control group (P = .036), and on POD 7 was 91.69% (8.71%) in the HBOT group and 83.12% (14.94%) in control group (P = .026). Donor site recovery was also significantly faster in the HBOT group, with a mean (SD) of 15.16 (0.88) days in the HBOT group and 17.97 (2.49) days in the control group (P < .001). In the control group, floating grafts were found in 2 patients, flap necrosis occurred in 4 patients, and 1 patient died due to sepsis, whereas in the HBOT group, significant graft contracture and wound recipient site infection occurred in 1 patient each.

HBOT significantly improved the percentage graft uptake in posttraumatic wounds and resulted in better donor site healing compared with standard care alone.