Ann Plast Reconstr Surg | Volume 8, Issue 1 | Research Article | Open Access
Smriti B, Karthick G, Raja T* and Maneesh S
Department of Plastic, Reconstructive and Burns Surgery, All India Institute of Medical Sciences, India
*Correspondance to: Raja Tiwari
Fulltext PDFIntroduction: Flaps can experience ischemia or mechanical obstruction because of their inherent traits. Arterial insufficiency or venous congestion are common causes of flap compromise. Surgically correctable causes of flap compromise must be immediately reversed. However, in cases where no rectifiable etiology is found during surgical re-exploration, HBOT may improve flap survival. However, conclusive evidence of its efficacy in salvaging compromised flaps in humans is lacking.
Aims and Objectives: To assess the efficacy of hyperbaric oxygen therapy in patients with compromised flaps and to propose an institutional protocol for hyperbaric oxygen therapy for compromised flaps.
Materials and Methods: HBOT is given for flap compromise after addressing mechanical causes. Therapy was administered 6 days/week. Regular clinical assessments were performed to evaluate tissue viability, vascularity, and stability. Initially, ten treatment sessions were planned for each patient. The ischemic or congested portion of the flap's dimensions was recorded before starting HBOT. A senior resident who was not included in the study, assessed clinical observations before and after HBOT to avoid bias. We used the paired t-test to compare pre-HBOT parameters with post-HBOT parameters, and a p-value of <0.05 with 95% Confidence Interval was considered statistically significant. We performed statistical tests using Microsoft Excel software.
Conclusion: HBOT can salvage a portion of a compromised flap, but secondary procedures may still be necessary. The results are promising, but further investigation is needed to determine its efficacy.
Hyperbaric Oxygen Therapy (HBOT); Compromised flaps salvage; Debridement; Flap necrosis
Smriti B, Karthick G, Raja T, Maneesh S. Role of Hyperbaric Oxygen Therapy in Salvage of Compromised Flaps. Ann Plast Reconstr Surg. 2024; 8(1): 1115..