Compromised Skin Grafts and Flaps

Skin grafts and flaps are used to cover large wounds. Hyperbaric oxygen therapy can help grafts and flaps heal when they are not getting enough blood flow and oxygen and have become compromised. During hyperbaric oxygen therapy, you breathe pressurized oxygen while you lie inside a clear plastic tube. The extra oxygen helps your body repair damaged tissue and fight infection. Each treatment can take up to 2 hours. Side effects from the treatment are rare.

Hyperbaric [hahy-per-bar-ik] or high-pressure oxygen therapy is a treatment for many kinds of illnesses and injuries, including problems with skin graft and skin flap healing. During this treatment, you breathe pure oxygen in a special chamber where the air pressure is two or three times higher than normal. This lets your lungs take in more oxygen than they normally can. The extra oxygen helps your body heal and fight infection.

Hyperbaric oxygen therapy is usually considered safe and side effects are rare. However, there are some risks associated with the high air pressure used. These risks include:

• Ruptured eardrum
• Collapsed lung
• Temporary nearsightedness (not being able to clearly see things that are far away). This usually goes away in a few days or weeks after your last treatment.

Another risk with hyperbaric oxygen therapy is seizure [see-zher] caused by having too much oxygen in your body. This is not life-threatening.

Pregnant women should not have hyperbaric oxygen therapy.

Large wounds are sometimes covered with a skin graft or skin flap. A graft is a piece of skin that is moved from another part of your body to cover the wound and heal in place. A flap is a piece of skin from near the wound that is still partly attached and is moved to heal over the wound. Sometimes grafts and flaps don’t get all of the blood flow and oxygen they need to heal well. This is called a compromised [kom-pruh-mahyzd] graft or flap.

Hyperbaric oxygen can help your compromised skin graft or flap by bringing more oxygen to the area. Extra oxygen helps your body build new blood vessels, heal damaged tissue, and fight infection. els, heal damaged tissue, and fight infection.

You should not drink any alcohol within 8 hours of hyperbaric oxygen therapy.

Because oxygen can cause a fire if there is a spark, you should never bring a lighter or any device with a battery in it into the treatment area.

You should avoid skin care products with petroleum jelly before treatment. Petroleum is also a fire hazard around oxygen.

Hyperbaric oxygen therapy usually is given at a special outpatient clinic. If you are already hospitalized, you might get this treatment in the hospital. You will lie on a table inside a long clear plastic tube. The tube will be sealed and filled with pressurized oxygen. You might feel popping or fullness in your ears, like the way you feel taking off in an airplane. If this happens, it can help to swallow or yawn.

The clinic staff will be able to see and hear you during your treatment and you can talk to them. You should try to relax and breathe normally. You might be able to watch TV or listen to music. Your treatment can take up to 2 hours. Then the tube will be slowly depressurized. You might feel tired or lightheaded afterwards. This should go away soon.

You may need as many as 20 to 40 treatment sessions with hyperbaric oxygen for a compromised skin graft or flap. You might start by getting two treatments each day, then switch to one treatment a day when you begin to get better.

You should try to keep all of your appointments for hyperbaric oxygen therapy. Each treatment builds on the one before to help you get better.

Stopping smoking improves blood flow to your skin graft or flap and can also help you heal.

Follow all of your doctor’s instructions for taking care of your skin graft or flap, and know what problems you should watch for and tell your doctor about.

After a hyperbaric oxygen treatment, you should:

• Get plenty of rest for the next 24 hours.
• Drink lots of fluids; avoid alcohol and caffeinated drinks such as coffee, tea, and colas.
• Avoid taking hot showers or tub baths until your doctor says it’s OK.
• Not participate in any strenuous activities for 48 hours.
• Not fly in any private or commercial aircraft for at least 24 hours.