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Objectives: Hyperbaric oxygen therapy (HBOT) and autologous platelet-rich plasma (PRP) have individually demonstrated potential in enhancing tissue regeneration through improved oxygenation and growth factor delivery. This study evaluates the clinical outcomes of a combined therapeutic approach using HBOT and PRP in patients with signs of compromised tissue perfusion after surgery. Introduction: Hyperbaric oxygen therapy (HBOT) has long been recognized as an adjunctive treatment for ischemic wounds and compromised flaps by delivering 100% oxygen at high pressure to stimulate angiogenesis, reduce edema, and support leukocyte and fibroblast function . Platelet-rich plasma offers an additional regenerative strategy by promoting neovascularization, tissue repair, and reducing local inflammation . While both therapies have demonstrated individual effectiveness in managing ischemic wounds , their combined use in postoperative ischemia has not been widely studied Materials / method: This is a prospective case series involving four patients treated in our clinic between August 2023 and July 2025. All patients presented with clinical signs of compromised tissue perfusion—such as delayed capillary refill, discoloration, cyanosis, venous statis and decreased local temperature—within the early postoperative period (day 1). These findings were suggestive of localized tissue ischemia. Results: All patients demonstrated significant improvement in tissue perfusion and wound healing after the initiation of combined protocol for HBOT and PRP therapy. Early signs of revascularization – such as improved skin coloration, warmth and capillary refill – were observed within 72 hours of treatment. None of the patients required surgical debridement, flap revision, or systematic antibiotic therapy. Conclusion: The observed improvements in tissue perfusion, color and wound stability suggest a great synergistic regenerative effect. The combination of those two therapies appears safe, well-tolerated by the patients and may reduce the need for surgical revision