Answer:
HBO therapy is a form of treatment in which the patient is placed in a chamber which contains oxygen at increased atmospheric pressure.
HBO treatments have been proposed as an adjunct to salvage of compromised free and pedicled flaps. Multiple laboratory studies in animals including rats, rabbits, and pigs have demonstrated the favorable impact of HBO on survival of compromised flaps. However, the clinical data currently available seem insufficient to support HBO treatments as a routine adjunct to surgery. Reports of flap failure in the setting of HBO therapy vary widely, ranging from 10% to 67%.
Current recommendations are to reserve HBO for possible use only in threatened flaps, although clinical data to support such recommendations is still scarce. According to Kindwall (PRS 1991; 88:904), treatment is usually given at 2 to 2.4 atmospheres for 90 to 120 minutes twice a day. This is continued for 3 to 10 days depending on the flap involved and its clinical appearance. Complications are rare but potentially include seizures thought to be related to oxygen toxicity and decompression-related effects such as middle ear pain and pneumothorax.
Given the expense ($1500 to $5000) and risk of complications, the circumstances for when HBO therapy can be used should be considered on a case-by-case basis.