The use of hyperbaric oxygen therapy in bony reconstruction of the irradiated and tissue-deficient patient.

Eighteen bony reconstructions of the mandible or maxilla using a newly defined and specific hyperbaric oxygen protocol are reported. Eleven of 12 grafts in irradiated tissue met six rigid criteria for a 91.6% rate of success. All six grafts into scarred and deficient tissue beds also met the same criteria, for an overall success rate of 94%. The rationale for emphasizing preoperative tissue preparation using hyperbaric oxygen is discussed, as are the mechanisms of action of hyperbaric oxygen on a biochemical, cellular, and tissue level. Neovascularity and neocellularity are demonstrated histologically by human biopsy specimens, and this is suggested as being the reason for the excellent results of reconstruction in irradiated and/or deficient tissue beds.