HBO Emergencies: Graft/Flap Compromise & Burns
Graft / Myocutaneous Flap Compromise.
Split thickness skin
grafts and myocutaneous flaps are utilized to close tissue when will not heal
by itself via secondary intention or wound fill. Frequently these flaps and
grafts were placed into tissue which is suboptimal for healing either because
of previous infection, radiation therapy, impaired vascularity etc.
Hyperbaric therapy has demonstrated in numerous animal studies as well as
human studies to significantly increase the graft survival in compromised
grafts and Flaps. Perrins and colleagues demonstrated the complete survival
of grafts occurred in 64% of hyperbaric treated patients as opposed to only
17% of controls (Lancet 1:868-71,1967). Hyperbaric oxygen therapy is also
used prophylactically to prepare the receptor bed in this setting of prior graft
rejection. At the first signs of skin graft or myocutaneous flap rejection
hyperbaric should be instituted in order to prevent loss.
Compromised Myocutaneous Flap
Thermal Burns are an emergent indication for hyperbaric oxygen therapy.
Burns are a complex injury with a zone of ischemia and spreading necrosis.
Early debridement and subsequent split thickness skin grafting is the usual
therapeutic course. The addition of Hyperbaric oxygen in both human and
animal studies has been shown to decrease the level of injury and decrease
the number of split thickness skin grafts to repair the tissue defect.
Hyperbaric therapy has special utility in the management of areas in which
debridement and grafting is problematic such as the face and hands.
Split Thickness Skin Grafting
HBO Saves Lives and Limbs
Web Site Designed and Created by Robert David Tufft MD
HBO Emergencies: Graft/Flap Compromise & Burns
Graft / Myocutaneous Flap Compromise.
Split thickness skin
grafts and myocutaneous flaps are utilized to close tissue when will not heal
by itself via secondary intention or wound fill. Frequently these flaps and
grafts were placed into tissue which is suboptimal for healing either because
of previous infection, radiation therapy, impaired vascularity etc.
Hyperbaric therapy has demonstrated in numerous animal studies as well as
human studies to significantly increase the graft survival in compromised
grafts and Flaps. Perrins and colleagues demonstrated the complete survival
of grafts occurred in 64% of hyperbaric treated patients as opposed to only
17% of controls (Lancet 1:868-71,1967). Hyperbaric oxygen therapy is also
used prophylactically to prepare the receptor bed in this setting of prior graft
rejection. At the first signs of skin graft or myocutaneous flap rejection
hyperbaric should be instituted in order to prevent loss.
Compromised Myocutaneous Flap
