Failed skin grafts and flaps
Skin graft – a segment of skin separated completely from its bed and
transplanted to another site.
Flap
– tissue (skin and subcutaneous) transferred from one site to another
with intact vascular supply or attached to donor site vessels.
Many factors can contribute to necrosis of skin grafts and flaps such
as;
In flaps - ischemia, edema, hematoma, arterial vasospasm, arterial or
venous occlusion, thrombosis and infection.
In grafts – improper recipient wound (hypoxic, infected and without
adequate granulation (healthy) tissue formation.
All
above described are leading to failure of skin grafts and flaps and are
associated with increased morbidity, repetition of surgical procedures
and hospitalization.
Clinical application of HBO:
Benefits of hyperbaric oxygen therapy in survival of skin grafts and
flaps are:
- Relief of tissue hypoxia and ischemia
- Improvement in microcirculation
- Increased number and size of blood vessels
- Reduction of swelling and vasospasm
- Prevention of thrombosis by suppression of platelet
aggregation
- Elimination of toxic metabolic products (lactate)
- Preparation of a viable vascular bed for the graft
- Prevention or suppression of infection
- Enhancement of wound healing
- Reduction of scar formation
