The Effect of Hyperbaric Oxygen on Compromised Grafts and Flaps

Area of Science:

• Reconstructive Surgery
• Tissue Engineering
• Hyperbaric Medicine

Background:

• Grafts and flaps are essential in reconstructive surgery, but can become compromised due to various factors.
• Compromised grafts/flaps may result from hypoxic wound beds, ischemia, or trauma, necessitating urgent salvage interventions.
• Hyperbaric oxygen therapy (HBOT) presents a potential adjunct for managing compromised grafts and flaps.

Purpose of the Study:

• To review the scientific and clinical evidence supporting the use of HBOT for compromised grafts and flaps.
• To elucidate the mechanisms by which HBOT enhances graft and flap survival.
• To emphasize the importance of timely HBOT initiation for maximizing tissue viability.

Main Methods:

• Review of existing basic science and clinical literature on HBOT for graft and flap salvage.
• Analysis of studies investigating the effects of HBOT on tissue viability and healing.
• Synthesis of evidence regarding HBOT's role in managing various etiologies of graft/flap compromise.

Main Results:

• Evidence supports HBOT as a beneficial adjunctive therapy for multiple graft and flap types.
• HBOT enhances graft and flap survival by reducing hypoxia, improving fibroblast function, stimulating angiogenesis, and mitigating ischemia-reperfusion injury.
• The literature demonstrates HBOT's efficacy across diverse causes of tissue compromise.

Conclusions:

• Adjunctive HBOT is a valuable tool for salvaging compromised grafts and flaps in reconstructive surgery.
• HBOT offers significant benefits by improving tissue oxygenation and promoting healing mechanisms.
• Early administration of HBOT upon identification of compromise is critical for successful tissue salvage and improved patient outcomes.