An evidence-based appraisal of the use of hyperbaric oxygen on flaps and grafts
An evidence-based appraisal of the use of hyperbaric oxygen on flaps and grafts
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DOI：
10.1097/01.prs.0000222555.84962.86
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发表时间：
2006-06-01
影响因子：
3.6
通讯作者：
Vecchiolla, T.
中科院分区：
文献类型：
--
作者：
Friedman, H. I. F.;Fitzmaurice, M.;Vecchiolla, T.
人们提倡将高压氧作为辅助或主要治疗方法，用于治疗多种疾病，包括气性坏疽、放射性骨坏死和一氧化碳中毒。它还用于在植皮前改善缺血性伤口并支撑缺血性皮瓣。在这篇综述中，我们分析了现有的文献，这些文献研究了高压氧在复合移植物、皮肤移植物、随机皮瓣、远端皮瓣和游离皮瓣中的应用。对高压氧的每种用途的证据水平进行了评估。尽管有大量的动物数据支持高压氧在移植物和皮瓣中的应用，但除了病例报告和系列之外，几乎没有临床信息来支持其相对于其他治疗方式的选择。显然需要进行多中心前瞻性临床研究，将高压氧与其他机械或药物干预措施进行比较，以改善移植伤口愈合或支持皮瓣存活。
Hyperbaric oxygen has been advocated, both as an adjunctive or primary form of treatment, for a variety of disorders, including gas gangrene, osteoradionecrosis, and carbon monoxide poisoning. It has also been used to improve ischemic wounds before skin grafting and to support ischemic flaps. In this review, we analyze the available literature that investigates the use of hyperbaric oxygen for composite grafts, skin grafts, random flaps, distant flaps, and free flaps. An appraisal of the level of evidence for each of these uses of hyperbaric oxygen is offered. Although there are a significant amount of animal data supporting the application of hyperbaric oxygen for grafts and flaps, there is very little clinical information other than case reports and series to sustain its choice over other modalities of therapy. Multicenter prospective clinical studies are clearly needed comparing hyperbaric oxygen to other mechanical or pharmacologic interventions to improve wound healing for grafting or to support flap survival.