Hyperbaric oxygen therapy for skin flap transplantation: a meta-analysis

Despite the continued improvement in surgical skills and flap design, the incidence of necrosis after skin flap transplantation remains high. Hyperbaric oxygen therapy (HBOT) has been shown to be effective in improving wound healing after skin flap transplantation and this meta-analysis evaluates its role such patients.

A search of research databases-PubMed; Web of Science; ClinicalTrials.gov; the Cochrane Library; China Knowledge Network; Wanfang; and Weipu-from database establishment to 26 June 2023 for randomised controlled trials (RCTs) on the effects of HBOT on wound healing in patients undergoing skin flap transplantation was conducted. RevMan 5.3 statistical software (Nordic Cochrane Centre, Denmark) was used for data analysis.

A total of 13 RCTs involving 1226 patients who had undergone skin flap transplantation were included in the analysis. The studies showed that HBOT could: significantly improve the survival rate of the skin flap in patients (odds ratio (OR): 8.57; 95% confidence interval (CI): 5.54, 13.26); increase the skin blood oxygen saturation of the skin flap (mean difference (MD): 19.94; 95% CI: 18.16, 21.72) and the postoperative skin temperature of patients (MD: 0.71; 95% CI: 0.54, 0.89); reduce the time for swelling to subside (MD: -3.76; 95% CI: -4.34, -3.18), and the time taken for skin to become ruddy (MD: -4.56; 95% CI: -5.28, -3.84) (all p<0.05).

The findings of this meta-analysis shows that HBOT improved the survival rate of skin flaps and accelerated skin recovery in patients undergoing skin flap transplantation.