Definition and Causes

A skin graft is a piece of skin transplanted onto a complex wound. A skin flap includes skin plus deeper tissues, sometimes muscle, blood vessels, and bone. Wound care specialists and reconstructive and plastic surgeons commonly perform skin transplants.

Skin grafts and flaps require a healthy, oxygenated wound bed to heal. Success may be compromised by an improperly prepared transplant site, the poor circulatory health of the patient, radiation treatment, or other factors.

Treatment with Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) is used both to prepare wound sites before transplant and to aid in healing after transplant of skin grafts and flaps. HBOT works by enhancing blood circulation and tissue oxygenation in the wound bed.

As with other conditions, a qualified physician must evaluate the patient to determine the cause of inadequate circulation in the effected tissue and the appropriate course of treatment.


Undersea and Hyperbaric Medical Society

Mechanisms of HBO2

Hyperbaric oxygen therapy (HBO2T) is neither necessary nor recommended for the support of normal, uncompromised grafts or flaps. However, in tissue compromised by irradiation or in other cases where there is decreased perfusion or hypoxia, HBO2T has been shown to be extremely useful in flap salvage. Hyperbaric oxygen can help maximize the viability of the compromised tissue thereby reducing the need for regrafting or repeat flap procedures.
The criteria for selecting the proper patients that are likely to benefit from adjunctive hyperbaric oxygen for graft or flap compromise is crucial for a successful outcome. Identification of the underlying cause for graft or flap compromise can assist in determining the proper clinical management and use of hyperbaric oxygen therapy.
A number of studies have shown the efficacy of HBO2T on enhancement of flap and graft survival in a variety of experimental and clinical situations.

As with other conditions, a qualified physician must evaluate the patient to determine the cause of inadequate circulation in the effected tissue and the appropriate course of treatment.

 

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