Medically focused information for patients and referring providers in Newmarket and York Region.
Skin graft surgery is meant to be a turning point. Whether it follows trauma, burns, infection, cancer treatment, a diabetic wound, radiation injury, or reconstructive surgery, the goals are similar: cover the damaged area, protect the wound, restore function, and help the body heal.
Most grafts succeed. Split-thickness skin grafts have a reported success rate of about 70% to 90%, which means a graft that struggles is a recognized part of wound and reconstructive care — not a rare failure or a sign that something was done wrong.
But sometimes, despite careful surgery, a graft does not take the way everyone hoped. The area may look pale, dusky, swollen, or fragile, or it may be slow to heal. That can be worrying. This article explains where hyperbaric oxygen therapy (HBOT) may fit into the recovery conversation — and, just as importantly, where it does not.
At York Hyperbaric Medicine Centre, HBOT is delivered as a medical treatment, with the aim of improving oxygen delivery to injured, under-supplied, or non-healing tissue. It can be a useful supportive tool when healing needs more than time alone.
What does it mean when a skin graft “fails”?
A skin graft is a piece of skin moved from one part of the body to another. Unlike a flap, a graft has no blood supply of its own — it depends on the wound bed beneath it for oxygen and nutrients while new blood vessels grow in. In the first days it is fragile and vulnerable.
A graft can be compromised by poor circulation, heavy swelling, infection, pressure or shear, radiation-damaged tissue, or trauma. A failing graft does not always mean the whole result is lost. Sometimes only part of the graft is struggling, and the tissue is at risk but still salvageable. Identifying the problem early gives the body the best chance to recover.
Is HBOT actually recognized for skin grafts?
Yes — for the right situation. This is an important point for patients comparing their options. Health Canada lists “skin grafts and flaps that are not healing well” among the 14 specific conditions for which hyperbaric oxygen therapy is a recognized, effective treatment.
HBOT is not used for normal, healthy grafts. The Undersea & Hyperbaric Medical Society (UHMS) is explicit: hyperbaric oxygen is “neither necessary nor recommended” for normal, uncompromised grafts or flaps. But in tissue compromised by radiation, or where there is reduced blood flow or low oxygen (hypoxia), the UHMS notes that HBOT “has been shown to be extremely useful in flap salvage” and can help reduce the need for regrafting or repeat procedures.
In other words, HBOT has a focused role: it can help tissue that is already in trouble because of low oxygen, poor circulation, radiation damage, infection risk, or slow healing.
Why oxygen matters for graft healing
Healing is not luck. Your body needs oxygen to build new tissue, fight infection, make collagen, support immune cells, and grow new blood vessels. When oxygen levels in the wound area are too low, healing can stall.
Think of a new graft like a young plant. It needs the right environment to root, connect, and grow. If the “soil” — the wound bed — is dry or damaged, the plant struggles. Oxygen helps create healthier conditions for healing.
During HBOT, a patient breathes oxygen inside a pressurized chamber. As Health Canada describes it, the pressure allows much more oxygen to dissolve into the blood and reach body tissues than usual. For a compromised graft, that extra oxygen can be especially meaningful, because the core problem is often the oxygen-starved tissue environment around the graft.
How HBOT may support a compromised skin graft
When a graft is failing, the worry is usually that cells are not getting enough oxygen to survive and repair. By raising the oxygen available to the surrounding tissue, HBOT may help in several ways: it can support the growth of new blood vessels, reduce swelling, and make immune cells more effective against infection.
It is important to be clear about what HBOT is not:
- It is not a replacement for surgery.
- It is not a substitute for wound care, infection control, pressure relief, good nutrition, blood-sugar management, or surgical follow-up.
- It is an adjunctive therapy — a support to the primary treatment plan, used when clinically appropriate.
That is exactly why a medically focused setting matters. At York Hyperbaric Medicine Centre, patients are not stepping into a wellness trend — they are accessing a therapy with a recognized role in wound and tissue healing, delivered by a team focused on safety and appropriate treatment planning.
When might HBOT be considered?
HBOT may be discussed when a graft or flap is considered compromised — for example because of poor blood supply, radiation-damaged tissue, circulation problems related to diabetes, infection, trauma, excessive swelling, repeat surgery to the same area, a slow-healing wound, or burn injury.
Warning signs to watch for after graft surgery
A surgeon or wound care specialist may look for signs that a graft is at risk, such as:
- A change in colour (pale, dusky, or darkening)
- Slow or stalled healing
- Tissue breakdown or the graft opening up
- Increasing pain
- Heavy drainage or new odour
Do not “wait and see” if something looks wrong after surgery. The earlier a compromised graft is identified, the more options there may be to support it. Contact your surgeon, wound care provider, or hyperbaric medicine team promptly.
The emotional side of a struggling graft
When a skin graft struggles, it can feel personal. Patients often ask, “Did I do something wrong?” or “Does this mean another operation?” Many are already tired from weeks or months of wound care, and may be managing pain, limited mobility, diabetes, cancer recovery, or time away from work and family.
A failing graft is not only a medical issue — it is an emotional one. That is why clear communication matters: patients deserve a team that explains what is happening in plain language, answers questions, and works alongside the broader medical team.
What to expect during HBOT
During treatment, the patient rests inside a hyperbaric chamber and breathes oxygen while the session is supervised by trained staff. Patients receive instructions before treatment begins.
Is it painful? For most people, no. The most common sensation is pressure in the ears during pressurization — similar to an airplane taking off or landing — and the care team teaches patients how to equalize ear pressure safely. As with any medical therapy, HBOT carries some risks and is not suitable for everyone, so a hyperbaric physician reviews each person’s history first. It should always be delivered in a proper medical setting with trained staff and safety protocols.
HBOT is support, not a shortcut
One of the biggest misconceptions about HBOT is that it is a quick fix. It is not. A compromised graft still needs excellent wound care — dressings, offloading, antibiotics if there is infection, nutrition support, blood-sugar control, compression when appropriate, and surgical follow-up.
HBOT supports the healing environment and gives oxygen-starved tissue a better chance. The best outcomes usually come from coordinated care, not from any single treatment on its own.
Why choose York Hyperbaric Medicine Centre
York Hyperbaric Medicine Centre provides wound care and HBOT to patients in Newmarket and York Region. For someone recovering from graft surgery, having a hyperbaric centre close to home can reduce travel stress and make it easier to stay consistent with treatment.
And consistency matters. The length of an HBOT course depends on the condition and the treatment plan, so being near care can make a real difference for patients already juggling appointments, dressings, mobility, and caregiver support. The goal is never to overpromise — it is to support healing with a therapy that has a recognized role in compromised grafts and flaps when it is clinically appropriate.
The bottom line
A failed or failing skin graft is disappointing — but it does not always mean the result is lost. HBOT may help as part of a broader medical plan when tissue is struggling because of low oxygen, poor circulation, radiation damage, infection risk, or slow recovery.
If a graft is not healing well, the most important first step is to talk with your surgeon, wound care provider, or hyperbaric medicine team as soon as possible. Surgery gives the body a repair plan. HBOT may help give that plan the oxygen support it needs.
Frequently asked questions
- Can HBOT save a failed skin graft?
HBOT may help a failing graft by delivering more oxygen to tissue that is struggling to heal. It does not guarantee that further surgery won’t be needed, but in appropriate cases it can support tissue viability alongside surgical and wound care management. - When should HBOT be started after a graft problem is noticed?
Graft concerns should be assessed quickly. If you notice colour change, slow healing, tissue breakdown, worsening pain, or drainage, contact your surgeon or wound care provider right away. Early evaluation may open up more options for support. - Is HBOT painful?
Most patients do not find HBOT painful. Some feel ear pressure during pressurization, much like flying. The team explains how to manage this before treatment begins. - Does York Hyperbaric Medicine Centre require a referral?
The right pathway depends on your condition and care plan. The simplest step is to call York Hyperbaric Medicine Centre directly at (289) 803-9119 to ask about assessment, referral needs, and booking. - Is HBOT a replacement for surgery or wound care?
No. HBOT is generally an adjunctive therapy — a complement to the main treatment plan. Continue to follow your surgeon’s or wound care team’s guidance on dressings, medications, offloading, blood-sugar control, and follow-up appointments.
This article is for general information only and is not a substitute for professional medical advice, diagnosis, or treatment. Hyperbaric oxygen therapy is not appropriate for every patient or every graft. Always speak with your physician, surgeon, or a qualified hyperbaric medicine provider about your individual situation. To ask whether HBOT may be appropriate for you, contact York Hyperbaric Medicine Centre at (289) 803-9119.
References
- Braza ME, Marietta M, Fahrenkopf MP. Split-Thickness Skin Grafts. StatPearls (updated Feb 14, 2025). ncbi.nlm.nih.gov/books/NBK551561 — reported graft success rate of 70–90%.
- Undersea & Hyperbaric Medical Society. Compromised Grafts and Flaps (HBO Indication 12). uhms.org/12-compromised-grafts-and-flaps.html — HBOT not recommended for normal grafts; useful for hypoxic, poorly perfused, or irradiated tissue.
- Health Canada. Hyperbaric Oxygen Therapy (It’s Your Health). canada.ca — Hyperbaric Oxygen Therapy — lists “skin grafts and flaps that are not healing well” among 14 recognized HBOT indications; describes how HBOT works.
