Adjunct hyperbaric oxygen therapy in periorbital reconstruction
R. S. Gonnering, E. P. Kindwall and R. W. Goldmann
The abundant blood supply normally found in the periorbital region grants
the reconstructive surgeon many options for repair. When this blood supply
is altered by such factors as thermal damage or scar formation, classic
methods of lid reconstruction may not suffice. In such situations,
treatment with hyperbaric oxygen accelerates the process of primary
revascularization of full-thickness skin grafts and large composite grafts.
Augmentation of capillary budding occurs because hyperbaric oxygen therapy
raises the tissue oxygen tension in hypoxic areas to the level needed for
extracellular deposition of collagen, which is needed for support of
endothelial cells. Hyperbaric oxygen also appears to improve the survival
of ischemic skin flaps of the face, although the exact mechanism of this
action is unclear. Since 1982, a total of six patients needing periorbital
reconstruction has been treated postoperatively with adjunct hyperbaric
oxygen. Although the results have been uniformly favorable, a matched
series comparing the results with and without hyperbaric oxygen therapy
will be required to prove the efficacy of this treatment regimen.
