Friedman H I, Fitzmaurice M, Lefaivre J F, Vecchiolla T, Clarke D
University of South Carolina, School of Medicine, USA.
Plast Reconstr Surg. 2006 Jun;117(7 Suppl):175S-190S; discussion 191S-192S. doi: 10.1097/01.prs.0000222555.84962.86.
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.
高压氧已被提倡作为辅助或主要治疗方式，用于多种病症，包括气性坏疽、放射性骨坏死和一氧化碳中毒。它还被用于在皮肤移植前改善缺血性伤口以及支持缺血皮瓣。在本综述中，我们分析了现有文献，这些文献研究了高压氧在复合移植、皮肤移植、随意皮瓣、远位皮瓣和游离皮瓣中的应用。对高压氧这些应用的证据水平进行了评估。尽管有大量动物数据支持高压氧在移植和皮瓣中的应用，但除了病例报告和系列研究外，几乎没有临床信息来支持其优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。
