Subscribe to RSS

DOI: 10.1055/s-0044-1788592
Evaluating Hyperbaric Oxygen Therapy to Improve Single-Stage Dermal Substitute and Skin Grafting: A Comparative Study
Funding None.
Abstract
Background Dermal substitutes offer a valuable tool in soft-tissue reconstruction, reducing the need for donor site tissue and its associated complications. However, conventional approaches often require multiple surgeries. This study aimed to compare the effectiveness of a single-stage procedure combining dermal substitute and skin grafting with hyperbaric oxygen (HBO) therapy to the standard multistage protocol.
Materials and Methods A comparative study was conducted from January 2022 to December 2023. The medical records of 24 patients who underwent soft-tissue reconstruction were reviewed. Patients were categorized into two groups based on whether they received HBO therapy (HBO group) or followed the standard multistage protocol (control group). Outcomes were compared between the groups.
Results The study included 18 males and 6 females with an average age of 43 years (range: 5–91 years). Underlying medical conditions included diabetes mellitus (n = 11) and peripheral vascular disease (n = 2). Wounds were due to various causes, including necrotizing fasciitis (n = 2), trauma (n = 10), diabetic ulcers (n = 6), postburn hypertrophic scars/contractures (n = 3), chronic ulcers (n = 1), and sternal wound dehiscence (n = 1). All the patients achieved successful wound closure with dermal substitute application, eliminating the need for additional surgery. Notably, the group receiving HBO therapy experienced a shorter overall hospital stay compared with the standard multistage group.
Conclusion This study demonstrates the effectiveness of dermal substitutes in soft-tissue reconstruction. Furthermore, the addition of HBO therapy in a single-stage procedure appears beneficial for successful outcomes, potentially reducing hospital stay compared with the traditional multistage approach.
Publication History
Article published online:
18 July 2024
© 2024. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Soejima K, Nozaki M, Sasaki K, Takeuchi M, Negishi N. Reconstruction of burn deformity using artificial dermis combined with thin split-skin grafting. Burns 1997; 23 (06) 501-504
- 2 Oh SJ, Kim Y. Combined AlloDerm® and thin skin grafting for the treatment of postburn dyspigmented scar contracture of the upper extremity. J Plast Reconstr Aesthet Surg 2011; 64 (02) 229-233
- 3 Duzgun AP, Satir HZ, Ozozan O, Saylam B, Kulah B, Coskun F. Effect of hyperbaric oxygen therapy on healing of diabetic foot ulcers. J Foot Ankle Surg 2008; 47 (06) 515-519
- 4 Halim AS, Khoo TL, Mohd Yussof SJ. Biologic and synthetic skin substitutes: an overview. Indian J Plast Surg 2010; 43 (1, suppl): S23-S28
- 5 Ryssel H, Gazyakan E, Germann G, Ohlbauer M. The use of MatriDerm in early excision and simultaneous autologous skin grafting in burns: a pilot study. Burns 2008; 34 (01) 93-97
- 6 Schneider J, Biedermann T, Widmer D. et al. Matriderm versus Integra: a comparative experimental study. Burns 2009; 35 (01) 51-57
- 7 Kolokythas P, Aust MC, Vogt PM, Paulsen F. Dermal subsitute with the collagen-elastin matrix Matriderm in burn injuries: a comprehensive review. Handchir Mikrochir Plast Chir 2008; 40 (06) 367-371
- 8 Sen S, Sen S. Therapeutic effects of hyperbaric oxygen: integrated review. Med Gas Res 2021; 11 (01) 30-33
- 9 Phillips JC. Understanding hyperbaric oxygen therapy and its use in the treatment of compromised skin grafts and flaps. Plast Surg Nurs 2005; 25 (02) 72-80 , quiz 81–82
- 10 Ülkür E, Karagoz H, Ergun O, Celikoz B, Yildiz S, Yildirim S. The effect of hyperbaric oxygen therapy on the delay procedure. Plast Reconstr Surg 2007; 119 (01) 86-94
- 11 Bhutani S, Vishwanath G. Hyperbaric oxygen and wound healing. Indian J Plast Surg 2012; 45 (02) 316-324
- 12 Oley MH, Oley MC, Aling DMR. et al. Effects of hyperbaric oxygen therapy on the healing of thermal burns and its relationship with ICAM-1: a case-control study. Ann Med Surg (Lond) 2020; 61: 104-109
- 13 Niezgoda JAMD, Cianci P, Folden BWRN, Ortega RLRN, Slade JB, Storrow ABMD. The effect of hyperbaric oxygen therapy on a burn wound model in human volunteers. Plast Reconstr Surg 1997; 99 (06) 1620-1625
- 14 Francis A, Baynosa RC. Hyperbaric oxygen therapy for the compromised graft or flap. Adv Wound Care (New Rochelle) 2017; 6 (01) 23-32