Hyperbaric Oxygen Therapy for Salvage of Flaps with Unstable Blood Flow
Pp. 306-316 (11)
Satoshi Onoda, Shogo Azumi, Yuki Miura and Narushi Sugiyama
In plastic surgery, hyperbaric oxygen therapy is used to promote healing of
intractable ulcers caused by severe diabetes mellitus, peripheral circulatory disorders,
and severe scald burns. We performed hyperbaric oxygen therapy to improve blood
flow disorders of transferred flaps and reported the utility of and problems with this method.
We performed hyperbaric oxygen therapy for 10 patients with postoperative blood flow
disorder after flap transfer. All cases were reconstruction using pedicled flaps. Subject
disorders were intractable ulcers with myelitis in three cases, decubitus ulcers in three
cases, gas gangrene in one case, injury in one case, hair loss in one case, and defect
after tumor resection in one case. Among the 10 patients for whom we performed
hyperbaric oxygen therapy, eight experienced local chronic inflammation or systemic
wound healing protraction factors.
The transferred flaps in 4 of 10 patients treated with hyperbaric oxygen therapy were
salvaged, and the diseases were cured. In one patient, the flap was saved; however,
myelitis symptoms were caused by an intramedullary bone screw. The other five
patients showed epidermal or adiposal partial necrosis of the transferred flap and closed
We performed hyperbaric oxygen therapy for 10 patients with unstable flap blood flow.
A therapy effect was apparent in all cases, and supplemental surgical procedures were
not required in five cases. Hyperbaric oxygen therapy is a useful flap salvation method
for institutions that have access to hyperbaric oxygen devices.
Flap salvage, Hyperbaric oxygen therapy, Negative pressure wound
therapy, Pedicled flap, Skin graft.
Department of Plastic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1 Aoyama-cho, Kure 737-0023, Japan.