Compromised Skin Grafts and Flaps


The skin is the largest organ in the body. It has two main layers: the epidermis (outer layer) and dermis (inner layer). The dermis, containing the blood vessels, nerves, hair follicles, sweat and oil glands, nourishes the epidermis. It is made up primarily of protein collagen connective tissue that makes the skin flexible and provides structural support.

Skin grafting is a surgical procedure to place skin or skin substitute over a burn or non-healing wound to permanently replace damaged or missing skin or provide a temporary wound dressing. Sometimes these grafts fail (or become compromised) due to poor blood flow, swelling or infection.

According to the British Medical Journal (Oct. 1998), hyperbaric oxygen therapy improves both graft and flap survival compared with routine post-operative surgical care alone.

Hyperbaric oxygen therapy is an extremely effective therapy for tissues affected by a burn, radiation therapy or in patients with decreased perfusion or hypoxia. Some skin grafts (from a severe burn) or flaps (a graft which is moved and reattached along with the blood vessel that supplies it) may have trouble healing from swelling or poor blood flow.

Hyperbaric oxygen therapy works to maximize the viability of the compromised tissue, make collagen and reduce the need for re-grafting and repeat flap procedures. The treatment prepares a vascular and cellular tissue within the radiated wound to enable a surgeon to successfully debride and later reconstruct the wound.

Case Study

Post-Surgical Failed Left Knee Flap