Impact of Hyperbaric Oxygen Therapy in the Postoperative Period of Plastic Surgery

Hyperbaric Oxygen Therapy (HBOT) has emerged as a promising adjuvant strategy to optimize the postoperative course in plastic surgery, particularly regarding wound healing, flap survival, and the reduction of complications such as necrosis and infection. Common aesthetic procedures such as abdominoplasties, liposculptures, and rhytidectomies present complication rates ranging from 10% to 15% in the absence of HBOT, leading to prolonged hospital stays and increased healthcare costs. HBOT, by delivering 100% oxygen at pressures between 1.4 and 2.8 ATA, raises Tissue Oxygen Partial Pressure (PtO₂) to levels exceeding 1,000 mmHg, ensuring adequate oxygen supply even to hypoxic areas and activating molecular repair mechanisms. Retrospective clinical studies and recent meta-analyses indicate significant reductions in adverse events when HBOT is used prophylactically. In liposculpture and abdominoplasty, 10-session protocols at 2.0 ATA reduced complications from 14% to 10.7% and eliminated surgical wound infections. In rhytidectomies, patients undergoing HBOT had an average healing time of 13.3 ± 3.1 days compared to 36.9 ± 9.4 days in the control group, with postoperative hematomas virtually eliminated. In immediate post-mastectomy breast reconstruction, flap salvage rates increased from 65% without HBOT to 88% with HBOT, and reoperation rates dropped from 27% to 9% in irradiated patients. On a cellular and molecular level, intermittent hyperoxygenation inhibits pro-inflammatory cytokines (IL-1β, TNF-α) and stimulates angiogenic growth factors (VEGF, FGF-2, TGF-β1), enhancing fibroblast proliferation and collagen deposition. In vitro assays show up to 1.8-fold increases in cell proliferation at 2.4 ATA, accelerating early tissue repair phases. From an economic standpoint, although each HBOT session incurs direct costs, analyses indicate up to five days of reduced hospitalization and fewer surgical revisions, making the protocol potentially cost-effective for complex surgeries. The safety profile is favorable, with a very low incidence of severe adverse events (