The use of hyperbaric oxygen therapy in the treatment of necrotizing soft tissue infections, compromised grafts and flaps, hidradenitis suppurativa, and pyoderma gangrenosum

Abstract

Hyperbaric oxygen therapy (HBOT) is used in the management of a wide array of disease states, including acute thermal burn injuries, carbon monoxide poisoning, and decompression sickness, to name a few. Although HBOT is approved by the Undersea and Hyperbaric Medical Society for the treatment of only 14 conditions, it has been used "off-label" in the management of a variety of dermatological diseases. This review investigates the utilization of HBOT in dermatology and appraises the evidence behind its use. We focus on the role of HBOT in treating necrotizing soft tissue infections, compromised grafts and flaps, hidradenitis suppurativa, and pyoderma gangrenosum.

The effect of hyperbaric oxygen therapy combined with hair transplantation surgery for the treatment of alopecia

“…In previous work, the clinical advantages of HBOT as a therapeutic method were proved in the treatment of several neurological disorders, chronic wound, and auditory ailments. 10,11,16 In this study, we demonstrated that the integrated therapy of hair transplantation and HBOT can reduce the postoperative shedding rate of transplanted hair follicles and effectively overcome side effects of itching and folliculitis.…”

“…9,10 Furthermore, it is reported that HBOT can prevent necrosis or decrease necrotic tissue size, which laid foundation for further investigation. 11 Thus, the strong foundation of knowledge underpinning HBOT as a new adjuvant strategy for many diseases, such as paraplegia secondary to spinal cord injury, compromised graft, or flap transplantation. 10,12 Until now, there are few reports exploring the clinical efficacy of the integrated therapy of hair transplantation and HBOT.…”

Effect of hyperbaric oxygenation on random rat skin flaps vascularization

“…2 and Table 1 ), and the result indicated that the use of HBO promotes tissue viability in the experimental condition applied. It is a consensus in the literature that the increase in oxygen tension resulting from HBO, when blood pressure becomes elevated to 1,000-1,500 mmHg due to dissolution in plasma, improves cell function and promotes angioneogenesis 4 .…”

“…According to the results of GER and GER/HBO groups, it is highlighted the importance of stimulating the contact of the flap with the bed on which it was replaced for angiogenesis, with a significant response in the group submitted to HBO. However, further studies need to be carried out in order to investigate the use of HBO in compromised skin flaps 4 , 38 .…”

“…Thus, HBO is based on the dilution of oxygen in body fluids, which are usually under a pressure between 2 and 3 atmospheres absolute (ATA). For safety purposes, the hyperbaric chamber must withstand up to 1.5 times the maximum working pressure (4.5 ATA) 1 , 2 , 4 , 6 .…”