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Objective: In this review the literature aims to familiarize the reader with several of the more common plastic surgery problems and to review the appropriate use of HBO for each condition. Plastic surgery is a broad specialty encompassing a variety of areas including the treatment of traumatic soft tissue injury, burn care, hand surgery, microsurgery and limb replantation, problem wound management, flap reconstruction, cosmetic surgery, and congenital deformity. In recent years an emphasis on less anecdotal and more scientific research has provided a better understanding of the role of hyperbaric oxygen therapy (HBO) for many plastic surgical conditions. Patient selection remains the key to successful outcome. The rationale for HBO treatment of a specific plastic surgery problem should be based on scientific research if possible. If supportive research is not available or applicable to a specific case, then the decision to treat should be based on sound physiological principles.