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Postgrad Med J 2007;83:e1 doi:10.1136/pgmj.2006.051706
  • Case report

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
  • Received 21 July 2006
  • Accepted 25 September 2006

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.

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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