Defining the Role of Hyperbaric Oxygen Therapy as an Adjunct to Reconstructive Surgery

Surg Clin North Am. 2020 Aug;100(4):777-785. doi: 10.1016/j.suc.2020.04.003. Epub 2020 Jun 17.

Abstract

The discipline of reconstructive surgery has been slow to accept the role of hyperbaric oxygen therapy (HBOT) as an adjunct to surgery, despite clinical and experimental data showing potential benefits. Obstacles prevent this acceptance; one of the most potent is surgeon bias. This article attempts to lessen this bias by reviewing the benefits of HBOT in conditions where there is uniform acceptance of its role, such as carbon monoxide poisoning and decompression illness. It demonstrates that these conditions have similar pathophysiologic derangements to conditions commonly encountered by the reconstructive/wound care surgeon, including crush injuries, compartment syndrome, compromised flaps, and thermal burns.

Keywords: Burn; Compartment syndrome; Compromised flap; Crush injuries; Hyperbaric oxygen; Reconstructive surgery; Reperfusion injury.

Publication types

  • Review

MeSH terms

  • Burns / therapy*
  • Carbon Monoxide Poisoning / therapy
  • Combined Modality Therapy
  • Compartment Syndromes / therapy
  • Crush Injuries / therapy
  • Decompression Sickness / therapy
  • Humans
  • Hyperbaric Oxygenation / methods*
  • Plastic Surgery Procedures / methods*
  • Surgical Flaps