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Current Use of Hyperbaric Oxygen Therapy in Plastic Surgery: A Systematic Review
Julissa Molina-Vega1, Catherine T Cascavita1, Rachel E Pferdehirt2
1From the David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.
Plastic and Reconstructive Surgery. Global Open
|August 6, 2026
Summary
Hyperbaric oxygen therapy (HBOT) aids plastic surgery by improving wound healing and limb salvage. While reducing complications, further research is needed for optimal protocols.
Area of Science:
- Plastic Surgery
- Hyperbaric Medicine
- Wound Healing
Background:
- Hyperbaric oxygen therapy (HBOT) uses 100% oxygen at elevated pressures.
- HBOT is applied in plastic surgery for ischemic wounds, flaps, and tissue injury.
- Comprehensive evaluations of HBOT in plastic surgery are limited.
Purpose of the Study:
- To systematically review the indications, complications, and outcomes of HBOT in plastic surgery.
- To evaluate HBOT's efficacy in wound healing, infection control, and tissue salvage.
- To synthesize evidence on HBOT's role in plastic surgery applications.
Main Methods:
- Systematic review conducted in February 2025 using PubMed, Embase, and Cochrane databases.
- Adherence to Preferred Reporting for Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Inclusion of studies evaluating HBOT for wounds, grafts, flaps, infections, and limb salvage in plastic surgery.
Main Results:
- 18 studies involving 1281 patients met inclusion criteria.
- Meta-analysis suggested a 52% reduction in complication rates with HBOT, though heterogeneity was high.
- HBOT demonstrated significant improvements in infection control, wound healing, limb salvage, and flap/graft survival.
Conclusions:
- HBOT shows promise as an adjunctive treatment in plastic surgery.
- Key applications include chronic wounds, limb preservation, and salvage of flaps or grafts.
- Further standardized research is essential to establish optimal treatment protocols and patient selection criteria.
