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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]
Appears in following Topics:
Compromised Skin Grafts and Flaps