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Hyperbaric oxygen (HBO₂) treatment for a failing facial flap

Correspondence to:
Correspondence to:
Brian F McCrary
DO, 653 Ruby Drive, Vacaville, CA 95687, USA; brian.mccrary-02{at}travis.af.mil

Hyperbaric oxygen (HBO₂) is an approved treatment for 13 pathological entities. One of these indications—a failing facial flap—is presented in this case report of a traumatic wound to the face and right axilla after an unprovoked pit bull attack on a 4 year old girl. Surgical repair was started acutely but the facial flap became congested and ischaemic, indicating deterioration of the blood supply. HBO₂ treatments were initiated twice a day, resulting in remarkably decreased swelling and discomfort after the first treatment. Leeching was also used to assist with reduction of venous congestion in the flap. The patient was discharged 5 days later with a well perfused, mostly intact, incision with minimal tenderness. Surgical repair was required for a small area of wound dehiscence. Photographs documenting the patient’s progress with HBO₂ are presented. A discussion of the mechanisms of action of HBO₂ and its beneficial effects is provided in this case.

Abbreviations: HBO₂, hyperbaric oxygen; OMS, oral and maxillofacial surgery; PMNs, polymorphonuclear cells

Keywords: hyperbaric; oxygen; ischaemia; flap