Hyperbaric Oxygen Therapy in Plastic and Reconstructive Surgery

  • Dr. Marisse Venter, MBChB(UCT), FCS Plast Surg (CMSA), (WITS)
  • Volume 09 - Issue 2

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Ms. Debbie Dias is a breast cancer survivor. She was diagnosed with breast cancer in 2013 at the age of 44. She has a long period of chemotherapy, Debbie Dias is a breast cancer survivor. She was diagnosed with breast cancer in 2013 at the age of 44. She has a long period of chemotherapy, breast cancer surgery, first-stage breast reconstruction, and radiation therapy. She was extremely brave during a challenging, emotionally loaded time. Our lovely lady recently decided to continue her reconstructive process as a breast cancer survivor.

In order to facilitate second-stage breast reconstruction, we used hyperbaric oxygen therapy. Riedwaan Dass, at Milpark Hyperbaric Medicine Centre, always ensures that patients receive prompt treatment and guides patients during the crucial period before and after surgery where the greatest benefit from hyperbaric oxygen therapy is found.

Clinical studies have shown the benefits of hyperbaric oxygen therapy in the pre- and post-operative periods in breast surgery patients. In breast surgery, skin- and nipple- sparing mastectomies have revolutionized the cosmetic appearance post-cancer surgery. Maintaining blood supply post-skin and nipple-sparing mastectomy remains a significant reconstructive challenge.

Once the inside of the breast has been removed in the mastectomy operation, the breast skin has a thin layer of tiny blood vessels that keeps the outside breast envelope alive. Hyperbaric oxygen therapy works by increasing the oxygen-carrying capacity of the red blood cells within these tiny blood vessels. By maintaining the breast shape, we, as reconstructive surgeons, are able to obtain a far better reconstruction.

Radiation therapy has shown to significantly prolong life expectancy in breast cancer patients. Unfortunately, radiation therapy often causes tight contracted skin and hard lumps in fatty tissue making subsequent reconstruction difficult. We have found that hyperbaric oxygen therapy not only softens the radiated skin but also decreases the size of the fatty lumps. Once again, it is on the basis of the hyperoxygenation that the tissue quality improves much like a sprinkler system for your garden.

Studies have shown the beneficial effects of hyperbaric oxygen therapy to be at various levels in the process of wound healing. It increases the efficacy of white blood cells, kills bacteria, inhibits bacterial toxin formation, reduces swelling, maintains tissue oxygenation in the absence of adequate blood supply, stimulates fibroblast growth, increases collagen formation, promotes rapid growth of blood vessels, and terminates lipid peroxidation. Hyperbaric oxygen therapy helps to preserve ischemic tissue and has a role in radionecrosis.

The unique availability of a hyperbaric unit has enabled us to investigate the use of hyperbaric oxygen therapy in three main areas:

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  1. Maintaining nipple viability in nipple-sparing mastectomies.

  2. Maintaining skin flap viability inskin-sparing mastectomies

  3. Improving cosmetic appearance and symptoms associated with radio necrosis

We evaluated our findings in a clinical control trial utilizing 60 breast cancer patients that have had hyperbaric oxygen therapy post-cancer surgery as the intervention arm of the study. A historical control arm was used for comparison. Descriptive and inferential statistics were used to compare the study findings. Hyperbaric oxygen therapy has statistical value in maintaining tissue viability post-surgery. Hyperbaric oxygen therapy reduces the rate of liponecrosis associated with radiation therapy. Ms. Dias was one of the patients used in our study. Hyperbaric oxygen therapy has helped us to obtain a far better reconstruction, enabling Ms. Dias to feel feminine, restore her self-confidence, and return to her activities of daily function.

 

About the Author

Dr-Marisse-Venter

 

Dr. Marisse Venter, MBChB (UCT), Plast Surg (CMSA), (WITS) is a plastic and reconstructive surgeon. She has a special interest in wound healing, breast reconstruction and cosmetic surgery. Her work on the role of adipose derived tissue in wound healing and tissue regeneration has won her numerous national and international awards.

Dr. Venter qualified from the University of Cape Town in 2002. Her specialization encompassed four years of general surgery followed by four years of plastic surgery at the University of the Witwatersrand from where she qualified as a plastic surgeon in 2012. Dr. Venter is registered with the Health Professions Council of South Africa as a plastic and reconstructive surgeon. She is a member of the South African Association of Plastic and Reconstructive Surgeons, The South African Association of Aesthetic Surgeons and The International Association of Aesthetic Surgeons.

Following acting consultancy at the Helen Joseph Hospital, Dr. Venter has been in full-time private practice for the past six years.

Dr. Venter has dedicated her life to helping the plight of her patients, either by managing difficult wounds, reconstruction after breast cancer or general beautification in the most cost- effective manner.

For more information, visit www.breasthealth.co.za/Dr-Marisse-Venter.html

 

 

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