Clinical case of a patient with reduced blood flow to the flap after abdominoplasty – hyperbaric oxygenation with plasmotherapy to prevent necrosis

Clinical case: We present the case of a 39-year-old patient with a history of multiple previous in vitro procedures over the past 3 years. After the second procedure, she suffered an abortion with partial ischemic necrosis of the uterus. The patient reports high doses of progesterone during the second pregnancy. The patient has had two successful pregnancies and Cesarean section deliveries in the past. The patient underwent abdominoplasty, in which signs of vascular congestion of the flap were noted on the day after surgery. The applied hyperbaric oxygenation in combination with plasma therapy successfully protected the flap from further necrosis. Discussion: The hormonal therapies performed with subsequent necrosis of the uterus, as well as the existing scars from the Cesarean section, may be related to the circulatory deficiency of the postoperative wound from abdominoplasty. A key factor is early recognition of the problem, followed by a timely response and activation of the treatment protocol. It is questionable whether this type of therapy would have had such a beneficial effect if it had been started at a later stage. Conclusion: This case highlights the potential benefit of combining hyperbaric oxygen therapy and platelet-rich plasma to address postoperative problems with the blood circulation of the raised soft tissue flap and the wound healing processes. The combination of these two therapies is safe, well-tolerated by patients, and may reduce the need for surgical revision.