Hyperbaric oxygen therapy in managing fingertip injury after the thenar and V[sbnd]Y flap procedure: A case series

Abstract

INTRODUCTION: Injuries to fingertips are common due to their critical role in tactile sensation and hand function. Management options depend on injury severity and include conservative care, skin grafts, or flaps. The Ishikawa classification system helps guide treatment by categorizing injuries from soft tissue damage (Type I) to more severe bone and tissue loss (Type IV). Hyperbaric oxygen therapy (HBOT) has emerged as a valuable adjunct in enhancing wound healing and graft survival. CASE PRESENTATION: This report discusses five patients with fingertip injuries (FTI) of varying degrees, ranging from mechanical traumas to accidents involving parasailing and firecrackers. Their injuries were classified as Type II (n = 1), III (n = 2), and Type IV (n = 2) according to the Ishikawa system. Surgical interventions included thenar flaps for radial digit injuries in two patients and VY advancement flaps with full-thickness skin grafts in the other three. The grafts were harvested from the plantar foot. Following surgery, each patient underwent five HBOT sessions to support healing. CLINICAL DISCUSSION: The study observed that all five patients who underwent HBOT after surgical procedures experienced optimal graft healing. There were no signs of dehiscence, indicating that the grafts were well-integrated and functioning effectively. This outcome is attributed to the positive effects of HBOT on wound healing. CONCLUSION: HBOT accelerates wound healing, improves graft survival, and helps preserve function and aesthetics, making it an effective addition to surgical treatment. This case series supports further exploring HBOT in treating complex FTI to optimize patient outcomes.

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