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Hyperbaric oxygen (HBO2) treatment for a failing facial flap
  1. Brian F McCrary
  1. Correspondence to:
 Brian F McCrary
 DO, 653 Ruby Drive, Vacaville, CA 95687, USA; brian.mccrary-02{at}travis.af.mil

Abstract

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.

  • HBO2, hyperbaric oxygen
  • OMS, oral and maxillofacial surgery
  • PMNs, polymorphonuclear cells
  • hyperbaric
  • oxygen
  • ischaemia
  • flap

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Footnotes

  • Current position: Commander, Hyperbaric Medicine and Wound Care Center

  • The opinions, interpretations, conclusions, and recommendations are those of the authors and not necessarily endorsed by the United States Air Force.

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