title: Hyperbaric oxygen (HBO2) treatment for a failing facial flap.
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.
authors.affiliation: brian.mccrary-02@travis.af.mil
authors.forename: Brian F
authors.initials: BF
authors.lastname: McCrary
mesh_terms: D000818:Animals; D001733:Bites and Stings; D002675:Child, Preschool; D004285:Dogs; D005151:Facial Injuries / Q000601:surgery*; D005260:Female; D006084:Graft Rejection / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation; D007511:Ischemia / Q000628:therapy*; D016038:Skin Transplantation; D013524:Surgical Flaps / Q000098:blood supply*