Larson JV, Steensma EA, Flikkema RM, Norman EM, et al.
Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, In.... Date of publication 2013 Nov 1;volume 40(6):499-504.
1. Undersea Hyperb Med. 2013 Nov-Dec;40(6):499-504.
The application of hyperbaric oxygen therapy in the management of compromised
flaps.
Larson JV(1), Steensma EA(2), Flikkema RM(2), Norman EM(2).
Author information:
(1)College of Human Medicine, Michigan State University, East Lansing, Michigan,
USA.
(2)Western Michigan University School of Medicine, Department of Surgery,
Kalamazoo, MI, USA.
INTRODUCTION: Hyperbaric oxygen (HBO2) therapy has been used to promote viability
of compromised flaps despite a paucity of supportive clinical evidence. This
study provides an in-depth characterization of hyperbaric medicine to promote
flap survival and identifies treatment variables associated with positive
clinical outcomes.
METHODS: A retrospective review was conducted of patients who received HBO2
therapy for a failing or threatened post-reconstructive flap from 5/30/2008
through 4/30/2012. Medical records were reviewed to collect patient
characteristics, hyperbaric oxygen therapy details, and clinical outcomes.
Descriptive and comparative statistics were utilized.
RESULTS: Ninety-one patients underwent HBO2 therapy during this time period, with
15 patients meeting the selection criteria. Flap survival was achieved in 11
patients (73.3%). Of those successfully treated, four (36.4%) healed completely,
and seven (63.6%) demonstrated marked improvement. Patients who were treated
successfully demonstrated an average improvement in flap area of 68.3%. Variables
significantly associated with a favorable treatment outcome included a high
percentage of treatment completion (p = 0.022) and high pretreatment
transcutaneous oxygen measurements (p = 0.05). Smoking was a negative factor (p =
0.011).
CONCLUSION: This study provides clinical data characterizing and supporting the
application of hyperbaric medicine to aid in the viability of compromised flaps.
PMID: 24377192 [Indexed for MEDLINE]
