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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
- Regenerative Medicine
Background:
- Hyperbaric oxygen therapy (HBOT) uses 100% oxygen at increased atmospheric pressure.
- HBOT is applied in plastic surgery for ischemic wounds, compromised flaps, and tissue injury.
- Comprehensive evaluations of HBOT's indications, complications, and outcomes in plastic surgery are limited.
Purpose of the Study:
- To systematically review the evidence for hyperbaric oxygen therapy in plastic surgery.
- To evaluate HBOT's efficacy in various plastic surgery applications.
- To assess complications and outcomes associated with HBOT in plastic surgery.
Main Methods:
- A systematic review was conducted in February 2025 using PubMed, Embase, and Cochrane databases.
- Studies were selected based on Preferred Reporting for Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Included studies evaluated HBOT for wounds, grafts, flaps, infections, and extremity limb salvage.
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 improvements in infection control (up to 82.6%), wound healing (43.9%-100%), limb salvage (81%-94.4%), and flap/graft survival (64%-100%).
Conclusions:
- Hyperbaric oxygen therapy shows promise as an adjunct treatment in plastic surgery.
- HBOT is particularly beneficial for chronic wounds, limb preservation, and salvage of flaps or grafts.
- Further standardized research is necessary to establish optimal HBOT protocols and patient selection criteria.
