In these lesions, tissutal pO 2 levels range from 5 to 20 mmHg and this doesn't allow regular cell activity, but only cellular survival. Collagen deposition and fibroblastic cell proliferation begin when P O 2 levels are higher than 30 mmHg. On the basis of biological effects of H.O.T. protective effects for cutaneous limbs graft on reattachement are easily supposed. In these zones p O 2 ranges from 5 to 20 mmHg, these are low levels for a regular tissutal metabolic and cell proliferative activity. These conditions have been the basis for our research consisting in the association of H.O.T. and plastic reconstructive surgery.
Every patient is monitored for cardiorespiratory, otoiatric and methabolic conditions and Vit.
C and E are administrated for a variable period. Conclusion Biological and clinical knowledges suggested us the use of hyperbaric hyperhoxygenation consecutive periods underlining the importance of preoperatory treatment because of microcircolatory sofference of cutaneous limbs. Utilizing this therapy in the ischemic tissues PO 2 levels increase to 50-600 mmHg those are sufficient to allow normal cellular mechanism of tissutal reparation. High oxygen concentration in plasma and tissues around the graft or cutaneous limb causes the activation of leukocitary and of macrophagic aerobic methabolism and consequently increase of neoangiogenesis. In this conditions proline hidroxilation allows pre-collagen formation, so when there is not a sufficient oxygen concentration is impossible collagen fibrillar formation.