This 42 year old male diagnosed with a basal cell carinoma adjacent to his left ear. Patient underwent an extensive left sided resection involving the temporal bone and adjacent soft tissue, parotid gland, and selective node dissection. A trapezius flap and a split thickness tissue graft, from the thigh was used to graft over the temporal bony region. Five days post skin graft and flap the edges appeared slightly dusky. Evidence of increased ischemia and infection in the flap was noted on day ten. The graft and flap continued to fail despite aerobic and anaerobic coverage. On the twentieth day post grafting extensive debridement of the flap and graft was done due to failure.
Patient was then referred for HBOT for Compromised skin graft and flap. HBOT was initiated using a 90 minute treatment with BID treatment for first two days, remaining treatments on a daily basis.
Post tenth HBOT a good bed of granulation tissue was formed and partial regrafting was done. After the twentieth HBOT regrafting was completed. Patient received 26 HBOT with complete healing of the graft and flap.