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Compromised Skin Grafts and Flaps

Skin grafts are often used to replace lost skin due to open wounds, burns, and or other injury. Skin grafts are taken from a healthy area of the body and placed in the affected area. Skin grafts do not have their own blood supply so they rely on the underlying wound bed to provide the necessary oxygen and nutrients to survive. If the wound bed where the graft is placed does not have enough oxygen supplied to it, the skin graft may partially or completely fail. The reasons for a lack of oxygen in the wound bed may include diabetes, poor blood circulation, poor nutrition, smoking, underlying infection, and previous radiation injury.

A flap is multilayer tissue that is taken from a healthy area of the body and moved to the affected area. Unlike skin grafts, a flap either maintains its original blood supply or the blood supply is reestablished surgically. There are several types of flaps and surgeons select the one most appropriate for each situation. Flaps may also become compromised due to inadequate blood flow to supply the necessary oxygen and nutrients for the tissue’s cell to remain viable. Diabetes, poor blood circulation, nutrition, smoking, and various other factors may increase the chance for failure.

Grafts and flaps that become compromised may benefit from HBOT. HBOT reduces swelling in the area of the flap and delivers the oxygen needed for the skin and tissue to remain viable until the body can adequately establish new blood vessels to support it.

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