Hyperbaric oxygen therapy for complex wound management following breast cancer treatment: Single institution 10-year experience.

Abstract

Wound complications following mastectomy present significant challenges in breast cancer management, potentially delaying critical adjuvant therapies and compromising oncologic outcomes. This study evaluated our experience with hyperbaric oxygen therapy (HBOT) in treating nonhealing wounds after breast cancer surgery to facilitate timely completion of comprehensive cancer care. We conducted a retrospective review of patients who received HBOT for post-mastectomy wound complications at our institution between January 2014 and September 2024. Complications included partial nipple-areolar complex ischemia/necrosis, mastectomy flap necrosis, wound dehiscence, and radiation-induced skin changes. We assessed patient demographics, cancer characteristics, treatment timelines, HBOT parameters, and wound healing outcomes. Twenty patients underwent HBOT for post-mastectomy wound complications. All patients received treatment at 2.0 atmospheres absolute (ATA) in 90-min sessions, with a median of 30.5 sessions (IQR 25.5-58 sessions). Thirteen patients (65%) received perioperative radiation therapy. Most patients (90%) presented with mastectomy flap necrosis or wound dehiscence. Complete wound healing was achieved in all patients (100%), allowing continuation of planned oncologic therapies. Early HBOT initiation significantly correlated with faster healing times (p=0.023), potentially minimizing delays to cancer treatment. Only one patient experienced a transient adverse effect. HBOT served as an effective adjunctive treatment for compromised mastectomy wounds, achieving resolution in all cases while facilitating the completion of planned cancer therapies. It may reduce the need for surgical reintervention in select patients, with early initiation of therapy potentially optimizing both healing outcomes and oncologic treatment timelines. These findings support the incorporation of HBOT as part of a multidisciplinary approach to complex wound management in patients with breast cancer.