Hyperbaric Oxygen Therapy in Surgical Wound Healing and Tissue Salvage: A Structured Narrative Review

Surgical wound complications remain a major source of postoperative morbidity, particularly in the setting of tissue hypoxia, ischemia, and impaired perfusion. Hyperbaric oxygen therapy (HBOT) has emerged as an adjunctive modality aimed at enhancing tissue oxygen delivery and optimizing wound healing dynamics across diverse surgical contexts. A structured narrative review of the literature was conducted using PubMed/MEDLINE to identify clinical studies, systematic reviews, and translational investigations evaluating the role of HBOT in surgical wound healing and tissue salvage. The search included articles published from January 2000 to February 2026. Evidence was synthesized descriptively, focusing on mechanistic pathways, clinical indications, reconstructive applications, and reported outcomes. HBOT exerts therapeutic effects through multiple physiological mechanisms, including enhanced plasma-dissolved oxygen delivery, angiogenesis stimulation, fibroblast proliferation, collagen synthesis, and immunomodulation. Clinical evidence supports its use in chronic ischemic wounds, such as diabetic foot ulcers, venous leg ulcers, burn injuries, and radiation-induced tissue damage, demonstrating improved wound closure rates and reduced infection risk. In reconstructive surgery, HBOT has shown benefit in compromised grafts, ischemic flaps, traumatic soft-tissue injuries, and breast reconstruction salvage. Reported outcomes include enhanced tissue viability, reduced necrosis progression, improved graft integration, and decreased amputation rates in high-risk populations. HBOT represents a biologically active adjunct capable of enhancing surgical wound healing and tissue salvage through multifactorial regenerative mechanisms. As its applications continue to expand into reconstructive and aesthetic surgical domains, HBOT is positioned to play an increasingly integrative role within multidisciplinary perioperative care and complex wound management strategies.