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10 Year Review of the Role of Hyperbaric Oxygen Therapy in Treating Nonhealing Radiated Wounds after Mastectomy from a Single Institution
Fanru Shen, MD, Diwakar Phuyal, MD, Elad Fraiman, BA, MPH, Vincent Ferrini, MD, Eliana F.R. Duraes, MD, PhD, Risal Djohan, MD, MBA
Hospital center training program
2025-01-09
Presenter: Fanru Shen, MD
Affidavit:
Data collection was performed by Dr. Shen, Dr. Phuyal and Dr. Ferrini and analysis was performed by Dr. Shen and Elad Fraiman under supervision of Dr.Duraes and Dr. Djohan.
Director Name: Eliana F.R. Duraes, MD, PhD
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background: Immediate breast reconstruction after mastectomy improves functional and aesthetic outcomes, but up to 14% of patients experience flap necrosis, risking implant exposure, necessitating surgical revisions and potentially delaying cancer treatment. Hyperbaric oxygen therapy (HBOT) assists wound healing through promoting angiogenesis, enhancing collagen deposition, and antibacterial effects. This study evaluates the efficacy of HBOT in treating nonhealing wounds post-mastectomy.
Methods: A 10-year retrospective review analyzed patient demographics, risk factors for flap necrosis, mastectomy types, and reconstructions performed. Primary outcomes included time from the initiation of HBOT treatment to complete wound healing and the number of revision surgeries required.
Results: From January 2014 to September 2024, 20 patients received HBOT for wound complications after mastectomy, including 12 with reconstruction and 8 without. The mean age of patients was 60.4 years (range: 36–88), with an average follow-up of 20.5 months (range: 2–64). 12 patients (60%) had radiation therapy, and 8 (40%) had prior breast surgeries. 6 tissue expanders were salvaged with HBOT. Revision surgeries were necessary for 7 patients (35%), including 2 latissimus dorsi flaps, 1 free TRAM flap, and 1 DIEP flap.14 patients (70%) achieved complete wound healing, and 5 patients (25%) with incomplete HBOT showed significant improvement. Temporary vision changes occurred in only 1 patient.
Conclusions: At our institution, HBOT has proven effective in enhancing wound healing for nonhealing wounds following mastectomy, regardless of whether breast reconstruction was performed. The procedure was shown to be safe, with minimal complications. Larger-scale, multi-institutional randomised studies are recommended to validate these findings.
