A skin flap is defined as healthy skin and/or tissue that is moved to cover a wound. It typically includes tissue which has been only partially removed from one part of the body, so that it retains its own blood supply during transfer to another site.
Skin flaps are often used in reconstructive surgery—typically facial or breast—for patients who have survived cancer or undergone some form of physical trauma. By restoring the affected area, skin flaps serve to make non-healing wounds or scars more aesthetically appealing.
Let’s take a look at the different variations, the process of using skin flaps, and the beneficial effect hyperbaric oxygen therapy (HBOT) can have on the outcomes of these surgical procedures.
Generally speaking, skin flaps can originate from various parts of the body, depending upon the location and size of the designated recipient site. The types are defined as follows:
Distant Flap: Skin tissue is not located near the recipient site; it is eventually detached from the donor site upon transplantation by the surgeon.
Free Flap: Similar to distant; however, this flap is completely removed from the donor site prior to transplantation to the recipient site.
Local Flap: Skin tissue is not detached from the donor site, but rather, is stretched to cover the nearby recipient site.
Regional Flap: Similar to local; however, the donor site is not located near the wound.
Recovery time varies for routine skin flap procedures—depending upon the patient, his or her individual health, and the location and size of the donor and recipient sites—and can range from a few weeks to several months.
Ample rest is required, and wounds must be kept clean and covered. Depending upon the affected area, elevation may be recommended to help reduce inflammation and discomfort. In certain instances, your doctor may prescribe post-op medication.
In the event of a compromised or failed skin flap procedure, hyperbaric oxygen therapy is an FDA-approved treatment that can be administered following surgery to revascularize and increase the viability of the compromised tissue. Research evaluating the use of HBOT in failed skin flaps demonstrated that those treated with hyperbaric oxygen therapy had a complete flap survival rate of 64 percent, versus a 17 percent flap survival rate in the control group.
Patients should be cognizant of any swelling, darkening of the skin around the incision, and pain or irritation—however mild—as this could be a sign of a failed flap.