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Degree of improvement after hyperbaric oxygen therapy for compromised flap and graft: A case series

Kamonwan Jenwitheesuk, Ajanee Mahakkanukrauh, Wiyada Punjaruk, Kriangsak Jenwitheesuk, Palakorn Surakunprapha, Puttama Punyavong, Kengkart Winaikosol, Bowornsilp Chowchuen, Phasuk Limrattanapimpa

Objective: To determine the treatment outcome of hyperbaric oxygen therapy (HBOT) in compromised graft/flap.

Method: A retrospective study was conducted to identify patients who had undergone ischemic compromised graft and flap and received hyperbaric oxygen therapy at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand, between 2012 and 2017. Wound improvement was the primary outcome.

Results: Eleven patients with ischemic graft/flaps were enrolled in the study (9 adults; 2 children). The results showed that the treatment outcome for all patients undergoing skin flap/graft was improved. Patients classified as grade 3 and 4 (7 flaps in total) had improved wound healing without other adjunctive therapies whereas 4 patients-classified as grades 1 and 2-experienced partial wound healing and required surgical debridement with skin graft or flap reconstruction.

Conclusion: In flap or graft ischemia, HBOT represented an additional medical treatment that can enhance wound healing resulting in a satisfactory treatment outcome.