Successful Post-surgical Wound Management with Hyperbaric Oxygen Therapy

Abstract

Hyperbaric oxygen therapy (HBOT) is a treatment in which 100% oxygen at a pressure greater than one atmosphere is administered to the patient. It can be used as an adjunctive therapy in many wound care settings. We present a 41-year-old female, who had a prolonged hospital stay with an open abdominal wall dehiscence and scarring with multiple enterocutaneous fistulas. After her revisional surgery to resect the fistula, the patient developed ulceration and breakdown of her laparotomy wound. Hyperbaric oxygen therapy was initiated in addition to intensive wound care to stop the ulcer progression and promote the formation of granulation tissue.  Once therapy was completed, a split-thickness skin graft was performed on the granulation tissue to attain wound closure. Hyperbaric oxygen therapy exerts its effect mainly by adequate tissue perfusion and oxygenation. It also has a crucial role in neovascularization as well as activating signaling pathways to stimulate wound growth factors. In this case report, a combination of HBOT, wound care, and adequate nutrition resulted in the formation of a healthy granulation tissue bed. Subsequently, this resulted in the successful adherence of the skin graft. In addition to proper wound care and optimal nutritional support, HBOT can possibly play a role in enhancing wound healing in select cases.