Department

Plastic Surgery

Compromised grafts/flaps, post-procedure recovery, radiation injury, reconstructive cases

4 FDA-approved 1 research

HBOT Applications

FDA-Approved Level B

Compromised Skin Grafts & Flaps

Salvage adjunct for ischemic or venously congested skin grafts and flaps. Earlier initiation when perfusion issues are identified is associated with better outcomes; HBOT improves oxygen delivery, angiogenesis, fibroblast activity, and edema control.

Protocol

Pressure

2.0 – 2.5 ATA

Duration

60 – 90 min

Sessions

20 – 30

Frequency

Once daily, 5×/week

Evidence basis: UHMS / Standard of Care

References: 1 13 38
FDA-Approved Level A

Difficult Postoperative Wounds

Adjunctive HBOT for postoperative wounds with delayed healing, particularly in compromised tissue beds (radiation-injured, ischemic, or contaminated). Cross-references the FDA-approved problem-wound indication; the plastic surgery context emphasises early intervention when surgical revision alone is insufficient.

Protocol

Pressure

2.0 – 2.4 ATA

Duration

90 min

Sessions

20 – 30

Frequency

Once daily, 5×/week

Evidence basis: UHMS / Standard of Care

References: 1 7
FDA-Approved Level A

Radiation-Injured Tissue

HBOT for soft-tissue radiation necrosis preceding or following reconstructive surgery. Promotes angiogenesis in hypoxic, hypovascular, hypocellular tissue and improves outcomes in radiation-affected reconstruction.

Protocol

Pressure

2.0 – 2.4 ATA

Duration

90 min

Sessions

30 – 60

Frequency

Once daily, 5×/week

Evidence basis: UHMS / Standard of Care

References: 1 12
FDA-Approved Level A

Burns & Necrotizing Soft-Tissue Infection

Adjunctive treatment for severe burns, necrotizing fasciitis, and traumatic soft-tissue injury. Reduces mortality and tissue loss when combined with surgical debridement and antibiotic therapy.

Protocol

Pressure

2.0 – 2.5 ATA

Duration

90 min

Sessions

20 – 30

Frequency

Once daily, 5×/week

Evidence basis: UHMS / Standard of Care

References: 1 10
Emerging Evidence Level B

Aesthetic & Reconstructive Recovery

Comparative-outcome evidence in aesthetic and reconstructive recovery. A 2023 facelift case–control study (n=20) reported mean wound healing of 13.3 vs 36.9 days (P<.001) when HBOT was started within 24 h of surgery. Case series in cosmetic and reconstructive ischaemic soft-tissue wounds report consistent salvage benefit. HBOT is positioned as a salvage and recovery adjunct, not as a routine enhancer of uncomplicated cosmetic surgery.

Protocol

Pressure

2.0 – 2.5 ATA

Duration

60 – 90 min

Sessions

5 – 10 (aesthetic) / 20 – 30 (graft/flap salvage)

Frequency

Once daily; within 24 h of surgery for salvage cases

Evidence basis: Case–Control Study (Neel et al., 2023) + Reviews