HBOT for Skin Grafts and Flaps

What are Skin Grafts and Flaps?

When a wound is too large or complex to close on its own, surgeons often move healthy tissue from another part of the body to cover it.

A skin graft is a thin layer of skin moved without its own blood supply. At first it survives on oxygen that passes up from the wound bed underneath, until new blood vessels grow into it over the following days.

A skin flap is thicker tissue that can include fat, muscle or bone. It is moved with its own blood supply, either still attached at its base (a pedicled flap) or reconnected to blood vessels at the new site (a free flap).

Most grafts and flaps heal well. However, if the tissue does not receive enough blood and oxygen, part or all of it may fail. This is more likely after radiotherapy, in people who smoke or live with diabetes or circulation problems, and after large or complex reconstructions.

What is Hyperbaric Oxygen Therapy?

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Hyperbaric oxygen therapy (HBOT) involves breathing high-concentration oxygen through a mask in a pressurised chamber.

This allows more oxygen to dissolve into the bloodstream and reach tissues with reduced blood supply.

Oxygen plays a key role in many normal processes within the body, including healing and recovery. By increasing oxygen availability, HBOT can support tissue repair, collagen production, new blood vessel formation, and the body’s immune responses that help manage infection.

By reducing substances in the body that drive inflammation (inflammatory cytokines), HBOT may also help to ease swelling and discomfort.

HBOT is always used in addition to standard medical treatment, not as a replacement.

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When HBOT May be Considered for Skin Grafts and/or Skin Flaps

HBOT is sometimes considered as part of a wider care plan for skin grafts and flaps, particularly where:

The graft or flap shows signs of poor blood supply, such as a dusky or bluish colour, coolness, or slow healing.
Surgery is planned on tissue previously treated with radiotherapy.
Diabetes, smoking or circulation problems may affect healing.
A previous graft or flap has not taken and the wound is being prepared for further surgery.

HBOT may support the body’s natural repair processes.

A flap or wound area that suddenly changes colour, turns cold or becomes tense and swollen in the days after surgery needs urgent review. Please contact your surgical team or nearest accident & emergency department straight away. OxyGeneration does not provide emergency care.

Some people whose recovery is going well also choose HBOT as part of their wider recovery plan after surgery, ideally in discussion with their surgeon. Research in this setting is still developing, and HBOT is not considered necessary for grafts and flaps that are healing normally. You can read more on our Pre/Post Surgery page.

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Use of HBOT for Skin Grafts and/or Skin Flaps

Compromised skin grafts and flaps are a recognised indication for hyperbaric oxygen therapy. In grafts and flaps at risk, HBOT raises oxygen levels in the tissue while the body builds new blood vessels to support it. It also helps fibroblasts lay down collagen and can limit the damage that occurs when blood flow returns to tissue that has been starved of oxygen.

Research, including a small randomised trial in split-skin grafts and many clinical case series, shows better graft and flap survival when HBOT is added to standard care. Results are best when treatment starts as soon as a problem is recognised.

This indication is included in the approved indication lists of the Undersea and Hyperbaric Medical Society (UHMS) and the European Committee for Hyperbaric Medicine (ECHM). In Ireland, hyperbaric oxygen therapy is recognised by major private health insurers for selected indications, including compromised skin grafts and flaps.

OxyGeneration provides HBOT in a calm clinical environment, delivered by a trained and experienced team.

Some clients are referred by a healthcare professional, but self-referral is also welcomed. All clients complete a screening questionnaire to check suitability. In some situations, we may ask clients to confirm suitability with their GP or medical specialist before proceeding.

For skin grafts and skin flaps, a course of 10 - 20 sessions is common, with longer courses sometimes recommended where a wound is being prepared for further surgery. The number recommended will depend on individual circumstances and response to treatment. Where a graft or flap is at risk, contact your surgical team or A&E immediately. In terms of HBOT, the research indicates that HBOT is more effective if used earlier in the recovery process and more than one session a day may be advised in the first few days. HBOT is always used alongside, not in place of, the care provided by your surgical team, including surgical review and correction of any underlying cause, wound dressings, inflection management, blood glucose control and stopping smoking. We can work the client’s existing medical team to deliver the hyperbaric component of an integrated treatment plan.

OxyGeneration does not provide emergency medical treatment. We do not diagnose or manage medical conditions, and HBOT is not a replacement for standard medical care. Clients remain under the supervision of their GP or consultant for the management of their condition. As with all treatments, outcomes can vary from person to person.

If you would like to find out more about HBOT and whether it might be appropriate for you, please contact our team for more information.

What to Expect at OxyGeneration

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Important Information

Hyperbaric oxygen therapy is not suitable for everyone.

Please visit our Suitability page for further information.

Testimonial

“Using the hyperbaric chamber at OxyGeneration (5 sessions) has made a huge difference to my recovery from my second caesarean section in terms of speed of healing and a significant reduction of remaining scar tissue as compared to my first.”

— Joan, C-Section Scar Tissue Recovery