title: Use of HBOT and a living bilayer skin substitute for a compromised flap with chronic steroid use: a case report.
abstract: Wound healing in a degloving injury can be compromised due to mechanical compression, increased length-to-width ratio, and time to treatment. Chronic steroid use is also a known risk factor for poor wound healing in wounds of any type. We report the first known case of hyperbaric oxygen therapy and Apligraf, a living bilayer skin substitute, for non-operative salvage of a traumatic degloving injury in 70-year-old female on chronic steroids for sarcoidosis.
  
  
  BACKGROUND
  The authors have received no financial support for the material presented in this study outside of the scope of standard patient care reimbursement. The authors do not have any financial conflict of interest to disclose.
authors.affiliation: 1 General Surgery Chief Resident (PGY5), Asst. Professor, Plastic Surgery, Assoc. Prog. Director, PS Residency, University of Nevada School of Medicine, Division of Plastic Surgery, Las Vegas, Nevada USA.
authors.forename: A L
authors.initials: AL
authors.lastname: Pistorio
authors.forename: J
authors.initials: J
authors.lastname: Leslie
authors.forename: R B
authors.initials: RB
authors.lastname: Gustavson
authors.forename: R C
authors.initials: RC
authors.lastname: Baynosa
mesh_terms: D000368:Aged; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods*; D017768:Skin, Artificial; D013524:Surgical Flaps; D016896:Treatment Outcome; D014945:Wound Healing; D014947:Wounds and Injuries / Q000188:drug therapy*
chemical_list: D005938:Glucocorticoids
keywords: degloving injury; glucocorticoid; hyperbaric oxygen; sarcoidosis; traumatic injury; wound healing