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Compromised Skin Grafts and Flaps

What are Compromised Skin Grafts and Flaps?

 

When not enough blood and oxygen are delivered to the skin graft or flap it is at risk of failure and is considered compromised.  There are several reasons for compromised grafts including lack of blood supply due to local blood clots, vasoconstriction or narrowing of the arteries which provide blood to the graft or flap, prior radiation to the site, and local tissue swelling.    

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What is a Normal Skin Graft and Flap?

A skin graft involves the placement of skin from one part of the body to another to repair a defect in the skin due to trauma, infection, or a tumor.  A skin flap is similar to a skin graft, however, it involves other tissue structures such as muscle, fat, blood vessels, nerves, and skin.  Having a skin graft or flap is done as a surgical procedure by a physician with specialized training; such as a plastic surgeon, ENT, or burn surgeon.  The graft or flap normally heals within a few weeks following surgery allowing for return of function to the affected area. 

What are examples of Compromised Skin Grafts and Flaps?

Any type of skin graft or flap can become compromised, although large grafts or flaps, and those with limited blood supply, are at greater risk.  Some of the more common examples of surgical procedures involving skin grafts or flaps include cosmetic surgery, breast reconstruction, burn reconstruction, neck dissections, or amputations. 

 

How are Compromised Skin Grafts and Flaps treated Medically?

The first step in treatment of a compromised graft or flap is having the problem diagnosed by your surgeon.  Treatment can include changes to your dressing, addition of special vacuum-assisted wound dressing, treating infection, and possibly reoperation.

 

How are Compromised Skin Grafts and Flaps treated with Hyperbaric Oxygen?

After the initial management has begun, the addition of hyperbaric oxygen can be used to increase healing and reduce overall graft failure.  Hyperbaric oxygen does this by increasing oxygen delivery to the graft or flap, improving blood flow through the generation of new blood vessels, and increasing fibroblast function. 

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