RESUMO
Temporoparietal fascia flaps are reported to have a 94% success rate in auricular reconstruction. Bilayer matrix (Integra™, Integra LifeSciences, Plainsboro, NJ) dermal graft alone has an average success rate of 76.6%. When combined with fibrin glue and negative pressure therapy (V.A.C.® Freedom®, KCI, San Antonio, Tex) the flaps have a success rate of up to 98% in patients with a variety of wound types and sites. Two patients are presented with failed temporoparietal fascia flaps. In addition, one also had prior failure of a split-thickness skin graft; the second also had failure of prior Integra split-thickness skin graft, and hyperbaric oxygen therapy. All 3 treatment modalities of bilayer dermal graft, negative pressure therapy, and hyperbaric oxygen used simultaneously allowed both flaps to heal.
RESUMO
METHODS: We describe a case series of 11 patients with retinal artery occlusion treated with hyperbaric oxygen therapy (HBOT) at Intermountain Dixie Regional Medical Center between 2005 and 2009. We then combined data from our case series with data from two other case series to report on a combined total of 51 patients. RESULTS: Eight of our 11 patients achieved improved visual acuity. Analysis of the combined case series showed that 74 % of patients treated with HBOT had improvement in visual acuity (P < 0.0001) with 53 % improving two lines or more on a modified Snellen value. The combined case series also showed that visual acuity improved in all time-from-occlusion to treatment categories, ranging from less than 8 hours to six days. CONCLUSIONS: We recommend consideration of HBOT for patients who present with recent retinal artery occlusion. Hyperbaric centres treating these patients should consider forming a central registry of standardised data to prospectively study the results of therapy.