In well - perfused wounds where the healing process is sufficient through a balanced cellular metabolism HBO therapy is not necessary.
The proposed use of HBO as supplementary therapeutic intervention in the management of compromised flaps or grafts was based on the acquired experience of wound healing enhancement after HBO application in wounds and injuries of hypoxic soft tissues7' 8' 9 10' 11.
Compromised tissues are usually hypoxic thus the necessity for improved oxygenation. HBO has been shown experimentally/clinically able to support and restore healing mechanisms in hypoxic cellular environment7, 12 13.
Reduced perfusion and hypoxia are expressed with diminished tissular oxygen thus preventing cellular energy requirements involved in wound healing restoration.
Although the absolute limit of tissular hypoxia for healing is difficult to be defined, a level of 40 mmHg of wound oxygen is considered necessary14.
In compromised tissues a value of oxygen tension below 15 mm Hg is often detectable15.
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