Effect of hyperbaric oxygen therapy as a monitoring technique for digital replantation survival

There have been few clinical reports of successful replantation assisted wi th hyperbaric oxygen (HBO) therapy. In order to improve replant survival, t he author has used HBO in ten digital replantations of crush, avulsion, and degloving amputations. Seven of ten replants survived and the other three failed. The failed three digits demonstrated remarkable color changes durin g HBO therapy. No color changes were observed in six of the seven surviving digits under HBO. The remaining digit showed a slight color difference bet ween pre- and post-therapy. It appears that hyperbaric oxygen is potentiall y effective in distinguishing "uneventful" replants in which color does not change during HBO therapy, while hyperbaric oxygen could not salvage those "congestion to necrosis" replants in which the color became bright ver-mil ion under hyperbaric oxygen therapy. The difference in digital color reacti on to hyperbaric oxygen may be helpful in early decisions to employ salvagi ng procedures.