Skin graft not healing
If your skin graft is not healing properly, you’re not alone. Complications with grafts are common, but treatment options are available, including hyperbaric oxygen therapy (HBOT), which can support the healing process and improve blood supply to the graft site.
Non-healing skin graft
Why a skin graft might not be healing
A skin graft may not heal due to complications like infection, a hematoma or blood pooling, or poor blood circulation to the area. Other things that can interfere with healing include bumps or injury to the graft site, or too much movement while it’s still settling in. If you start to see any signs of infection, notice the graft lifting, experience increasing pain, or see that the area is turning dark, it’s best to reach out to your doctor or wound care team straight away.
Sometimes, it’s not what’s visible on the surface but what’s going on underneath. Grafts need a solid, well-oxygenated wound bed to attach and survive. If the surrounding tissue doesn’t have adequate blood flow, due to diabetes, vascular disease, or previous radiation, healing can slow down or stop entirely.
We often see grafts struggling to heal when the underlying tissue has low oxygen levels. In these cases, hyperbaric oxygen therapy (HBOT) may be considered as part of a broader wound care plan.
Skin graft not healing after surgery
What it looks like when things aren't going to plan
Skin grafts usually follow a familiar pattern. They appear pale at first, then slowly turn pink as new blood vessels form. However, if the graft stays dark, feels cool to touch, or starts to smell odd, it could be a sign that it’s struggling to heal.
Warning signs can include:
- Blackened or dusky skin (possible necrosis)
- Clear fluid under the graft (seroma or hematoma)
- Foul-smelling discharge
- Increased pain or swelling
- Graft detaching at the edges
These signs don’t always mean the graft has failed, but they are signals that something isn’t right. Catching problems early gives us the best chance to step in, support healing, and prevent things from getting worse.
Our focus is on supporting grafts through the critical early healing phase, when new blood vessels are forming. In some cases, early intervention may help avoid further surgical procedures.
Treating a non-healing skin graft
Strategies we use in complex wound care
At Wesley Hyperbaric, we often care for people whose grafts aren’t healing as expected. No two cases are quite the same, but the plan might include:
- Cleaning the wound bed – give the graft a better chance by gently removing dead or unhealthy tissue
- Keeping the wound moist – support healing by using specialist dressings like alginates, foams, or hydrocolloids
- Managing infection – taking swabs to choose the right antibiotics or using topical treatments when needed
- Reducing pressure – avoiding strain on the graft through offloading techniques and positioning adjustments
- Using HBOT when needed – for that are wounds struggling due to low oxygen or poor blood flow
Some grafts improve with just one of these strategies. Others need a combination to make progress. What matters most is treating the underlying cause, not just what’s visible on the surface.
How HBOT works to support healing
Hyperbaric oxygen therapy (HBOT) involves breathing pure oxygen in a pressurised chamber. The increased pressure allows more oxygen to dissolve into the blood plasma, helping it reach areas of tissue with poor blood flow. This extra oxygen supports cellular repair, reduces inflammation, and aids the body’s natural healing response.
For a skin graft not healing, hyperbaric oxygen therapy HBOT may be considered in appropriate cases to support tissue recovery alongside standard wound care.
- Enhancing angiogenesis – encouraging new blood vessel growth
- Stimulating fibroblast activity and collagen formation – essential for tissue repair
- Reducing swelling – through oxygen-induced vasoconstriction
- Improving immune response – by boosting white blood cell function
- Restoring oxygen delivery – especially in areas previously affected by radiation
When a graft is placed over challenging areas such as bone, tendon, or radiation-damaged tissue, HBOT may support healing in selected cases by improving local oxygenation.
Hyperbaric oxygen therapy (HBOT) is especially effective when wounds are hypoxic, contaminated, or showing signs of delayed healing. It’s used both proactively, after surgery to reduce risk, and reactively, as a rescue therapy when healing stalls.
Who benefits most from HBOT?
Skin grafts can struggle in anyone, but certain conditions make healing harder:
- Diabetes
- Peripheral arterial disease
- Radiation-damaged tissue
- Post-cancer surgery
- Pressure ulcers with exposed bone
- Previous failed grafts
Chronic wounds often come with more than one issue, such as poor circulation, lingering infection, or damage from earlier treatment. These overlapping problems can slow healing and make recovery harder. Hyperbaric oxygen therapy (HBOT) helps where healing has stalled by delivering oxygen deep into oxygen-starved tissue. This gives the body the boost it needs to restart the repair process.
Wesley Hyperbaric is a licensed day hospital. Hyperbaric-trained doctors are on-site during every session. Our chamber has room for multiple people to receive treatment at the same time. We work in close partnership with your existing care team to keep your treatment coordinated, clear, and continuous.
Hyperbaric oxygen therapy for skin grafts
What treatment looks like at Wesley Hyperbaric
Every hyperbaric oxygen therapy (HBOT) course starts with a referral from your GP or specialist. Immediately after your initial consultation, we’ll discuss a treatment plan that’s tailored to your graft’s condition and your overall health.
Medicare may cover some of the treatment, particularly if healing has slowed or the graft site has been affected by previous radiation. Eligibility is assessed case by case. We’ll guide you through each step, explain what’s covered, and make sure you feel supported from the very beginning.
Treatment typically involves:
- 90-minute sessions at 2.4 ATA pressure
- Five sessions per week (Monday to Friday)
- A treatment course of 20 to 40 sessions, depending on your needs
During each session, you’ll sit in a reclined chair inside our multiplace chamber, breathing oxygen through a clear hood. A nurse stays in the chamber with you the entire time to ensure your safety and comfort. Many patients use the time to read, listen to music, or simply rest.
The treatment is quiet and painless. Most patients are surprised by how calm and relaxed they feel once they’re inside the chamber.
Can a failed skin graft be saved?
Sometimes, yes. A graft that has failed completely might need surgery. But in many cases, partial loss can still be managed. The right care, such as keeping the wound moist, gently clearing damaged tissue, and boosting oxygen to the area can help stabilise a compromised graft.
Hyperbaric oxygen therapy (HBOT) can still help even when full healing isn’t possible. It may lower the risk of infection, slow tissue breakdown, and keep the graft viable, depending on the situation.
This is why early referral is so important. The sooner we step in, the more chances there are to support recovery without sending the patient back to the operation theatre.
Taking the next step
If your skin graft not healing is causing concern, speak with your doctor about advanced wound care or hyperbaric oxygen therapy. Grafts can be unpredictable, but they’re not beyond help. Many of our patients come to us after weeks or months of stalled progress. Some patients begin to see improvement once oxygen levels in the tissue are supported through wound care strategies, including HBOT where clinically appropriate.
Your journey starts with these 3 steps
When you have completed your hyperbaric sessions, your condition is reassessed by one of our doctors.